Associations Between Oral Clefts and Drugs Taken During Pregnancy

Abstract

Associations between drug consumption during pregnancy and the birth of children with oral clefts were studied in material from the Finnish Register of Congenital Malformations, consisting of 599 children with clefts and their matched controls. Information concerning maternal drug consumption was partly prospective. During the first trimester, analgesic, chemotherapeutic and antineurotic drugs had all been significantly more frequently used by the mothers of children with clefts, than by the control mothers. The consumption of drugs was in general more frequent among mothers of children with cleft lip, with or without cleft palate, than among those of children with cleft palate alone.

The effects of codeine on pregnancy outcome: Results from a large population-based cohort study

“…In this study, codeine use during pregnancy was not found to be associated with infant survival rate, congenital malformation rate, or other adverse pregnancy outcomes, except for Cesarean delivery and excessive postpartum hemorrhage. Unlike previous studies [4,5,7,8] and other medical literature sources that rely either on data regardng opioid analgesic use in general or a few case studies [9,13], we found no increased risk of congenital malformations or neonatal respiratory depression. Associations of codeine use during pregnancy and neonatal abstinence syndrome were unfortunately not feasible to evaluate, as neonatal abstinence syndrome scores were not routinely applied.…”

“…4-8.4] [4]. Another of 599 infants found that mothers who gave birth to infants with cleft palate or cleft lip with or without cleft palate used opioid analgesics (mainly codeine) much more frequently than the control group; the largest difference was seen for codeine use during the first trimester (8.6% compared with 2.1% of infants in the control group; P< 0.01) [5]. In a third case-control study of 1,370 infants, 12 infants with major congenital malformations had been exposed to codeine during the first trimester compared with seven in the control group (OR 3.7, Fisher's one-tailed P value 0.004) [6].…”

Folic acid–containing supplement consumption during pregnancy and risk for oral clefts: A meta‐analysis

“…Five prospective (Briggs, 1976;Conway, 1958;Czeizel, 1996;Czeizel et al, 2004;Tolarova and Harris, 1995) and 12 case-control Fraser and Warburton, 1964;Hayes et al, 1996;Hill et al, 1988;Itikala et al, 2001;Kallen and Olausson, 2002;Loffredo et al, 2001;Mitchell et al, 2003;Saxen, 1975;Shaw et al, 1995;van Rooij et al, 2003;Werler et al, 1999) studies were identified that met the inclusion criteria. None of the individual prospective studies demonstrated a statistically significant association at a ¼ 0.05 between folic acid supplementation and CLP, CP, or all clefts, respectively.…”

“…Not all clinical or epidemiological studies have reproduced the protective relationship implied by the Tolarova (Tolarova and Harris, 1995) study. In fact, the CIs bounding the relative risks (RRs) we derived from the published literature widely straddle the null value, and one study (Saxen, 1975) even indicates a marginally significant direct relationship. We undertook this metaanalysis to test the hypothesis that the nonsyndromic oral cleft birth prevalences are different for those whose mothers took folic acid-containing supplements during pregnancy and for those whose mothers did not.…”

Antibiotics in pregnancy: Toxicity and teratogenicity

“…In animals, malformations could be experimentally produced by sulfonamides (24), but in man there is only little evidence to suggest teratogenic effects. Only a few retrospective studies suggest a slight association of sulfonamides with malformations (2,25). Another side-effect of sulfonamides is caused by the competition of sulfonamides with bilirubin at common serum binding sites (26).…”