Risk of pre-term births and major birth defects resulting from paternal intake of COVID-19 medications prior to conception

BMC Res Notes. 2020 Nov 7;13(1):509. doi: 10.1186/s13104-020-05358-x.


Objective: With the ongoing COVID-19 pandemic, large numbers of people will receive one of the several medications proposed to treat COVID-19, including patients of reproductive age. Given that some medications have shown adverse effects on sperm quality, there might be a transgenerational concern. We aim at examining the association between drugs proposed to treat COVID-19 when taken by the father around conception and any pre-term birth or major birth defects in offspring in a nation-wide cohort study using Danish registry data. Offspring whose father filled at least one prescription of the following medications in the 3 months preceding conception were considered exposed: chloroquine, hydroxychloroquine, losartan, azithromycin, naproxen, dexamethasone and prednisone.

Results: For azithromycin and naproxen, large numbers of offspring were exposed (> 1800 offspring), and we found no association with adverse birth outcomes. For chloroquine, losartan and dexamethasone, exposure was intermediate (~ 900 offspring), and there was no statistically significant association with birth defects. For hydroxychloroquine and prednisone, exposure was limited (< 300 offspring). Our evidence suggests that azithromycin and naproxen are safe with respect to pre-term birth and birth defects. For the other drugs investigated larger exposures are needed for conclusive statements.

Keywords: COVID-19; Congenital malformation; Paternal reproductive safety; Pharmacological treatment; Pre-term birth.

MeSH terms

  • Abnormalities, Drug-Induced / epidemiology
  • Abnormalities, Drug-Induced / etiology*
  • Adult
  • Antiviral Agents / adverse effects*
  • COVID-19
  • COVID-19 Drug Treatment
  • Cohort Studies
  • Coronavirus Infections / drug therapy*
  • Denmark
  • Female
  • Humans
  • Male
  • Pandemics
  • Paternal Exposure*
  • Pneumonia, Viral / drug therapy*
  • Premature Birth / chemically induced*
  • Risk Assessment


  • Antiviral Agents