Journal article
Antifungal medication use during pregnancy and the risk of selected major birth defects in the National Birth Defects Prevention Study, 1997-2011
Pharmacoepidemiology and drug safety, Vol.33(1), e5741
01/2024
DOI: 10.1002/pds.5741
PMID: 38112229
Abstract
Recent studies suggest increased birth defect risk associated with maternal use of specific oral antifungals. We estimated associations between first-trimester antifungal use and selected non-cardiac birth defects using National Birth Defects Prevention Study (NBDPS) data.
Participants with a pregnancy affected by a study-eligible birth defect ("cases") were ascertained from 10 birth defect surveillance programs; participants who delivered livebirths without a major birth defect ("controls") were randomly selected from birth records or hospital discharge lists. First-trimester antifungal use was self-reported via maternal interview. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for birth defects with ≥5 exposed cases using logistic regression. We estimated crude ORs and exact 95% CIs for birth defects with 3-4 exposed cases. Additionally, we conducted a probabilistic bias analysis of exposure misclassification.
Our analysis included 19 624 cases and 11 427 controls; 257 (1.3%) cases and 123 (1.1%) controls reported first-trimester antifungal use. Of those who reported antifungals, 62.6% of cases and 64.2% of controls reported topical antifungals; 10.1% of cases and 4.9% of controls reported oral antifungals. We observed the strongest associations for encephalocele and Dandy-Walker malformation and modestly elevated estimates for several other defects. Bias-adjusted estimates were similar to the main analysis.
First-trimester antifungal use was positively associated with several birth defects in our analysis, although CIs were imprecise. Further study is warranted to investigate associations between antifungal use and birth defects, including potential bias due to confounding by indication.
Details
- Title: Subtitle
- Antifungal medication use during pregnancy and the risk of selected major birth defects in the National Birth Defects Prevention Study, 1997-2011
- Creators
- Eleni A Papadopoulos - Birth Defects Registry, Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, New York, USAMeredith M Howley - Birth Defects Registry, Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, New York, USASarah C Fisher - Birth Defects Registry, Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, New York, USAAlissa R Van Zutphen - University at Albany, State University of New YorkMartha M Werler - Boston UniversityPaul A Romitti - University of IowaMarilyn L Browne - University at Albany, State University of New YorkNational Birth Defects Prevention Study
- Resource Type
- Journal article
- Publication Details
- Pharmacoepidemiology and drug safety, Vol.33(1), e5741
- DOI
- 10.1002/pds.5741
- PMID
- 38112229
- eISSN
- 1099-1557
- Grant note
- CDC HHS
- Language
- English
- Electronic publication date
- 12/19/2023
- Date published
- 01/2024
- Academic Unit
- Epidemiology; Biostatistics
- Record Identifier
- 9984533456902771
Metrics
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