Conclusion
Our investigation of five CA signals related to macrolides found
negative results. While a positive association was not found between CHD
as a group and macrolides, an elevated risk was found between macrolides
and specific macrolides (erythromycin, clarithromycin and azithromycin)
and AVSD. We also found elevated risk for other defects associated with
first trimester use of specific macrolides that need further follow up
in independent datasets. Guidelines on the teratogenic risk of macrolide
use during the first trimester of pregnancy should take the current
findings into account. These results should also guide recommendations
for pregnant women when azithromycin is considered as part of COVID-19
treatment.