Purpose
We tested whether antihistamine exposure during early pregnancy is associated with spontaneous abortion (SAB) or preterm birth (PTB).
Methods
Women were enrolled in Right from the Start (2004-2010), a prospective pregnancy cohort. Data about first-trimester antihistamine use were obtained from screening and first-trimester interviews. Self-reported outcomes included spontaneous abortion and preterm birth and were verified by medical records. Cox proportional hazards models were used to test for an association between antihistamine use and each outcome, both performed adjusting for confounders.
Results
Among the 2,685 pregnancies analyzed, 14% (n=377) reported use of antihistamines. Among antihistamine users, 12% (n=44) experienced SABs, and 6% (n=21) had PTBs. Antihistamine exposure was not associated with SAB (adjusted hazard ratio [aHR]=0.88, 95% confidence interval [CI] 0.64, 1.21) or PTB, which was modified by maternal race (aHR=1.03, 95% CI 0.61,1.72 among White women and aHR=0.43, 95% CI 0.14, 1.34 among Black women).
Conclusions
Despite biologic plausibility that antihistamine use may influence pregnancy outcomes, we did not detect evidence of an association with SAB. These data demonstrate the utility of large prospective cohorts for evaluating drug safety in pregnancy when concerns are raised from animal models.