Nausea during Pregnancy and Congenital Heart Defects: A Population-based Case-Control Study

Boneva, Roumiana S.; Moore, Cynthia A.; Botto, Lorenzo D.; Wong, Lee Yang; Erickson, J. David

doi:10.1093/oxfordjournals.aje.a009880

Cited by 64 publications

(47 citation statements)

References 21 publications

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“…Specifically, case-control studies provide no consistent indication that maternal use of Bendectin during the first trimester of pregnancy increases the risk of congenital heart disease. 36,80,145,146 …”

Section: Composite Drugsmentioning

confidence: 99%

Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge

Jenkins¹,

Correa²,

Feinstein³

et al. 2007

Circulation

697

336

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Abstract-Prevention of congenital cardiovascular defects has been hampered by a lack of information about modifiable risk factors for abnormalities in cardiac development. Over the past decade, there have been major breakthroughs in the understanding of inherited causes of congenital heart disease, including the identification of specific genetic abnormalities for some types of malformations. Although relatively less information has been available on noninherited modifiable factors that may have an adverse effect on the fetal heart, there is a growing body of epidemiological literature on this topic. This statement summarizes the currently available literature on potential fetal exposures that might alter risk for cardiovascular defects. Information is summarized for periconceptional multivitamin or folic acid intake, which may reduce the risk of cardiac disease in the fetus, and for additional types of potential exposures that may increase the risk, including maternal illnesses, maternal therapeutic and nontherapeutic drug exposures, environmental exposures, and paternal exposures. Information is highlighted regarding definitive risk factors such as maternal rubella; phenylketonuria; pregestational diabetes; exposure to thalidomide, vitamin A cogeners, or retinoids; and indomethacin tocolysis. Caveats regarding interpretation of possible exposure-outcome relationships from case-control studies are given because this type of study has provided most of the available information. Guidelines for prospective parents that could reduce the likelihood that their child will have a major cardiac malformation are given. Issues related to pregnancy monitoring are discussed. Knowledge gaps and future sources of new information on risk factors are described.

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Section: Composite Drugsmentioning

confidence: 99%

Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge

Jenkins¹,

Correa²,

Feinstein³

et al. 2007

Circulation

697

336

View full text Add to dashboard Cite

show abstract

“…Comparing women with the most severe level of NVP to those with no NVP, the association between CHD and using any antinausea medication was protective with a relative risk estimate of 0.74 (95% CI: 0.56-0.97). Considering specific CHD subtypes, all associations among women with NVP, comparing those who took medications with those who did not, were below the null (but not statistically significant), with the exception of tetralogy of Fallot, which was greater than 1.0 (OR: 2.19; 95% CI: 0.39-22.32), based on 8 cases, 6 of whom took medication to treat NVP, compared with 2 who did not take medication 39 .…”

Section: Resultsmentioning

confidence: 80%

“…Four studies analyzed antihistamines in the aggregate only 36-39 , the remainder reported aggregated analyses in addition to analyses of specific antihistamines.…”

Section: Resultsmentioning

confidence: 99%

“…The population-based case-control studies included in this review 3, 39, 49, 53, 55, 66, 67 have the advantage of deriving cases from surveillance systems that, in general, attempt to capture all major birth defects cases occurring in a population. Most of the significant findings were reported in case-control studies which are typically better able to assess individual types of birth defects rather than being limited to an assessment of all birth defects as an aggregate group.…”

Section: Expert Opinionmentioning

confidence: 99%

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Antihistamines and birth defects: a systematic review of the literature

Gilboa

Ailes

Ramona

et al. 2014

Expert Opinion on Drug Safety

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Introduction Approximately 10-15% of women reportedly take an antihistamine during pregnancy for the relief of nausea and vomiting, allergy and asthma symptoms, or indigestion. Antihistamines include histamine H1-receptor and H2-receptor antagonists. Areas covered This is a systematic evaluation of the peer-reviewed epidemiologic literature published through February 2014 on the association between prenatal exposure to antihistamines and birth defects. Papers addressing histamine H1- or H2-receptor antagonists are included. Papers addressing pyridoxine plus doxylamine (Bendectin in the United States, Debendox in the United Kingdom, Diclectin in Canada, Lenotan and Merbental in other countries) prior to the year 2001 were excluded post-hoc because of several previously published meta-analyses and commentaries on this medication. Expert opinion The literature on the safety of antihistamine use during pregnancy with respect to birth defects is generally reassuring though the positive findings from a few large studies warrant corroboration in other populations. The findings in the literature are considered in light of three critical methodological issues: (1) selection of appropriate study population; (2) ascertainment of antihistamine exposures; and (3) ascertainment of birth defects outcomes. Selected antihistamines have been very well-studied (e.g. loratadine); others, especially H2- receptor antagonists, require additional study before an assessment of safety with respect to birth defects risk could be made.

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“…Reviewing all epidemiology studies on doxylamine, it is clear that while many studies show no increase in risk, a majority show some increase in risk compared with non-treatment [102][103][104][105][106][107][108][109][110][111][112][113][114].…”

Section: Discussionmentioning

confidence: 99%

Links between serotonin reuptake inhibition during pregnancy and neurodevelopmental delay/spectrum disorders: A systematic review of epidemiological and physiological evidence

Healy

Noury

Mangin

2016

JRS

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Abstract. OBJECTIVE:To investigate possible linkages between neurodevelopmental delay and neurodevelopmental spectrum disorders and exposure to medication with effects on serotonin reuptake inhibition during pregnancy. METHODS: We systematically reviewed the epidemiological literature for studies bearing on this relationship in children born with neurodevelopmental spectrum disorder and related conditions, as well as animal studies giving serotonin reuptake inhibitors to pregnant animals and in addition reviewed the literature for proposals as to possible mechanisms that might link effects on serotonin reuptake with cognitive changes post-partum.The epidemiological studies were analysed to produce Forest plots to illustrate possible relations. RESULTS: The odds ratio of Autistic Spectrum or related Disorders in children born to women taking serotonin reuptake inhibiting antidepressants during pregnancy in case control studies was 1.95 (95% C.I. 1.63, 2.34) and in prospective cohort studies was 1.96 (95% C.I. 1.33, 2.90).CONCLUSIONS: There appears to be a link between serotonin reuptake inhibition in pregnancy and developmental delay and spectrum disorders in infancy leading to cognitive difficulties in childhood. More work needs to be done to establish more precisely the nature of the difficulties and possible mechanisms through which this link might be mediated.Keywords: Autism spectrum disorder, neurodevelopmental delay, neurodevelopmental spectrum disorders, antidepressants, serotonin reuptake inhibitors, pregnancy BackgroundThe clinical syndrome later called autism was first reported in 1943 [1]. The first studies of the prevalence of autism or autistic disorder (AD) in the 1960s pointed to a rate of 4 per 10,000 [2,3]. Later studies indicated the existence of a spectrum of disorders, and brought the term autistic spectrum disorder (ASD) into being in the mid-1990s 126 D. Healy et al. / Link between SSRIs in pregnancy and autistic spectrum disordersand ASD also now includes other syndromes such as Pervasive Developmental Disorder and Aspergers Disorder so that it is difficult to know how closely current clinical usage of an ASD diagnosis maps onto AD and ASD as first conceived. Current estimates are that ASD in research studies occurs at a rate of more than 1 in 70 children [5,6].Kanner autism was recognized before the emergence of modern psychotropic drugs, and given its submergence in ASD, it may not now be possible to establish whether it is linked to commonly used psychotropic medications. A number of clinical pictures linked to psychotropic drug use, fetal anticonvulsant syndrome (FACS), fetal valproate syndrome (FVS), and fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorder (FASD) have been described since 1970. Aside from the link to treatment, the clinical features of these disorders are consistent with a diagnosis of ASD but not Kanner autism. A growing number of epidemiological studies point to an increase in rates of ASD. This translates popularly into concerns about a change in the p...

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Nausea during Pregnancy and Congenital Heart Defects: A Population-based Case-Control Study

Cited by 64 publications

References 21 publications

Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge

Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge

Antihistamines and birth defects: a systematic review of the literature

Links between serotonin reuptake inhibition during pregnancy and neurodevelopmental delay/spectrum disorders: A systematic review of epidemiological and physiological evidence

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