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Maternal asthma medication use and the risk of selected birth defects
Journal article   Open access   Peer reviewed

Maternal asthma medication use and the risk of selected birth defects

Shao Lin, Jean Pierre W Munsie, Michele L Herdt-Losavio, Charlotte M Druschel, Kimberly Campbell, Marilyn L Browne, Paul A Romitti, Richard S Olney, Erin M Bell and National Birth Defects Prevention Study
Pediatrics (Evanston), Vol.129(2), pp.e317-e324
02/2012
DOI: 10.1542/peds.2010-2660
PMCID: PMC5893143
PMID: 22250027
url
http://doi.org/10.1542/peds.2010-2660View
Open Access

Abstract

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. 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). 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). 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.
 United States Pregnancy Anti-Asthmatic Agents - adverse effects Bronchodilator Agents - therapeutic use Limb Deformities, Congenital - chemically induced Abnormalities, Drug-Induced - prevention & control Heart Defects, Congenital - chemically induced Anti-Asthmatic Agents - therapeutic use Humans Middle Aged Male Fluticasone Pregnancy Trimester, First Case-Control Studies Spine - abnormalities Young Adult Anti-Inflammatory Agents - adverse effects Heart Defects, Congenital - prevention & control Anti-Inflammatory Agents - therapeutic use Adult Female Bronchodilator Agents - adverse effects Trachea - abnormalities Limb Deformities, Congenital - prevention & control Abnormalities, Drug-Induced - epidemiology Risk Factors Radius - abnormalities Esophagus - abnormalities Asthma - drug therapy Pregnancy Complications - drug therapy Anal Canal - abnormalities Anus, Imperforate - chemically induced Kidney - abnormalities Limb Deformities, Congenital - epidemiology Anus, Imperforate - prevention & control Beclomethasone - adverse effects Heart Defects, Congenital - epidemiology Albuterol - therapeutic use Androstadienes - therapeutic use Beclomethasone - therapeutic use Androstadienes - adverse effects Albuterol - adverse effects Anus, Imperforate - epidemiology

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