Abstract

OBJECTIVES
Approximately 4% to 12% of pregnant women have asthma; few studies have examined the effects of maternal asthma medication use on birth defects. We examined whether maternal asthma medication use during early pregnancy increased the risk of selected birth defects.
METHODS
National Birth Defects Prevention Study data for 2853 infants with 1 or more selected birth defects (diaphragmatic hernia, esophageal atresia, small intestinal atresia, anorectal atresia, neural tube defects, omphalocele, or limb deficiencies) and 6726 unaffected control infants delivered from October 1997 through December 2005 were analyzed. Mothers of cases and controls provided telephone interviews of medication use and additional potential risk factors. Exposure was defined as maternal periconceptional (1 month prior through the third month of pregnancy) asthma medication use (bronchodilator or anti-inflammatory). Associations between maternal periconceptional asthma medication use and individual major birth defects were estimated by using adjusted odds ratios (aOR) and 95% confidence intervals (95%CI).
RESULTS
No statistically significant associations were observed for maternal periconceptional asthma medication use and most defects studied; however, positive associations were observed between maternal asthma medication use and isolated esophageal atresia (bronchodilator use: aOR = 2.39, 95%CI = 1.23, 4.66), isolated anorectal atresia (anti-inflammatory use: aOR = 2.12, 95%CI = 1.09, 4.12), and omphalocele (bronchodilator and anti-inflammatory use: aOR = 4.13, 95%CI = 1.43, 11.95).
CONCLUSIONS
Positive associations were observed for anorectal atresia, esophageal atresia, and omphalocele and maternal periconceptional asthma medication use, but not for other defects studied. It is possible that observed associations may be chance findings or may be a result of maternal asthma severity and related hypoxia rather than medication use.

Links

Publisher Full Text

Authors

Lin S, Munsie JP, Herdt-Losavio ML, Druschel CM, Campbell K, Browne ML, Romitti PA, Olney RS, Bell EM, National Birth Defects Prevention Study

Institution

Center for Environmental Health, New York State Department of Health, Troy, NY, USA.

Source

Pediatrics 129:2 2012 Feb pg e317-24

MeSH

Abnormalities, Drug-Induced
Adult
Albuterol
Anal Canal
Androstadienes
Anti-Asthmatic Agents
Anti-Inflammatory Agents
Anus, Imperforate
Asthma
Beclomethasone
Bronchodilator Agents
Case-Control Studies
Esophagus
Female
Heart Defects, Congenital
Humans
Kidney
Limb Deformities, Congenital
Male
Middle Aged
Pregnancy
Pregnancy Complications
Pregnancy Trimester, First
Radius
Risk Factors
Spine
Trachea
United States
Young Adult

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

22250027