Maternal antihypertensive medication use and selected birth defects in the National Birth Defects Prevention Study

Sarah C Fisher; Alissa R Van Zutphen; Martha M Werler; Paul A Romitti; Christopher Cunniff; Marilyn L Browne; National Birth Defects Prevention Study

doi:10.1002/bdr2.1372

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Maternal antihypertensive medication use and selected birth defects in the National Birth Defects Prevention Study

Journal article

Open access

Peer reviewed

Maternal antihypertensive medication use and selected birth defects in the National Birth Defects Prevention Study

Sarah C Fisher, Alissa R Van Zutphen, Martha M Werler, Paul A Romitti, Christopher Cunniff, Marilyn L Browne and National Birth Defects Prevention Study

Birth defects research, Vol.110(19), pp.1433-1442

11/15/2018

DOI: 10.1002/bdr2.1372

PMID: 30260586

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10064868/pdf/nihms-1874067.pdfView

Open Access

Abstract

There are limited data on the relationship between antihypertensive medication use in early pregnancy and risk of birth defects. Using data from the National Birth Defects Prevention Study, we examined associations between specific antihypertensive medication classes and 28 noncardiac birth defects. We analyzed self-reported data on 17,038 case and 11,477 control pregnancies with estimated delivery dates during 1997-2011. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals, adjusted for maternal age, race/ethnicity, body mass index, parity, pregestational diabetes, and study site, for associations between individual birth defects and antihypertensive medication use during the first trimester of pregnancy. We compared risk among women reporting early pregnancy antihypertensive medication use to normotensive women. Hypertensive women who reported early pregnancy antihypertensive medication use were more likely to be at least 35 years old, non-Hispanic Black, obese, multiparous, and to report pregestational diabetes than normotensive women. Compared to normotensive women, early pregnancy antihypertensive medication use was associated with increased risk of small intestinal atresia (adjusted OR 2.4, 95% CI 1.2-4.7) and anencephaly (adjusted OR 1.9, 95% CI 1.0-3.5). Risk of these defects was not specific to any particular medication class. Maternal antihypertensive medication use was not associated with the majority of birth defects we analyzed, but was associated with an increased risk for some birth defects. Because we cannot entirely rule out confounding by the underlying hypertension and most ORs were based on small numbers, the increased risks observed should be interpreted with caution.

Pregnancy

Infant, Low Birth Weight

Congenital Abnormalities - epidemiology

Intestine, Small - abnormalities

Anencephaly - etiology

Humans

Risk Factors

Self Report

Intestinal Atresia - etiology

Logistic Models

Male

Mothers

Case-Control Studies

Antihypertensive Agents - adverse effects

Abnormalities, Drug-Induced - etiology

Adult

Female

Odds Ratio

Infant, Newborn

Population Surveillance - methods

Prenatal Exposure Delayed Effects - chemically induced

Congenital Abnormalities - classification

Details

Title: Subtitle: Maternal antihypertensive medication use and selected birth defects in the National Birth Defects Prevention Study
Creators: Sarah C Fisher - New York State Department of Health, Congenital Malformations Registry, Albany, New York
Alissa R Van Zutphen - Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York
Martha M Werler - Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
Paul A Romitti - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
Christopher Cunniff - Department of Pediatrics, Weill Cornell Medical College, New York, New York
Marilyn L Browne - Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York
National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: Birth defects research, Vol.110(19), pp.1433-1442
DOI: 10.1002/bdr2.1372
PMID: 30260586
NLM abbreviation: Birth Defects Res
ISSN: 2472-1727
eISSN: 2472-1727
Publisher: Wiley; United States
Grant note: P30 ES005605 / NIEHS NIH HHS U01DD001032 / CDC HHS U01 DD001224 / NCBDD CDC HHS U01 DD001035 / NCBDD CDC HHS U01 DD001223 / NCBDD CDC HHS
Language: English
Date published: 11/15/2018
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9983995128402771

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