Use of antiemetic drugs during pregnancy in Sweden

Asker, Charlotte; Wikner, Birgitta Norstedt; Källén, Bëngt

doi:10.1007/s00228-005-0055-1

Cited by 75 publications

(39 citation statements)

References 15 publications

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“…Furthermore, the infants born to these women showed a female excess and an increased rate of twinning, which also agrees with what has been previously observed. 21 This was not seen for the other antipsychotics. It is likely that most women using dixyrazine or prochlorperazine used it because of NVP, but some may have used these drugs for psychiatric illnesses.…”

Section: Discussionmentioning

confidence: 88%

Maternal Use of Antipsychotics in Early Pregnancy and Delivery Outcome

Reis

Källén²

2008

Journal of Clinical Psychopharmacology

Self Cite

192

211

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The effect of various antipsychotics during pregnancy has repeatedly been studied, but for most atypical antipsychotics, only little information is available. We identified from the Swedish Medical Birth Register 2908 women who had reported the use of any antipsychotic or lithium in early pregnancy and studied malformation rates with data also from the Register of Congenital Malformations and the Hospital Discharge Register. Comparisons were made with all births (n = 958,729) after adjustment for some confounders. Risks were expressed as odds ratios (ORs). Most women had used dixyrazine or prochlorperazine mainly because of nausea and vomiting in early pregnancy. Seventy-nine women had used lithium, and these outcomes are reported separately. Hence, the main analysis was restricted to 570 women (576 infants) using other antipsychotics. There was a statistically significant increase in the risk for a congenital malformation-after exclusion of some common and minor conditions, the OR was 1.52 (95% confidence interval, 1.05-2.19). Exclusion of infants exposed to anticonvulsants reduced the OR only slightly. Most of the increased risk was caused by cardiovascular defects, mainly atrium or ventricular septum defect. No certain drug specificity was found. Except for an increased risk for congenital malformations, a nearly doubling of the risk for gestational diabetes and a 40% increased risk for cesarean delivery was noted. Because there seems to be little drug specificity, it is possible that underlying pathology or unidentified confounding explains the excess risk.

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Section: Discussionmentioning

confidence: 88%

Maternal Use of Antipsychotics in Early Pregnancy and Delivery Outcome

Reis

Källén²

2008

Journal of Clinical Psychopharmacology

Self Cite

192

211

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“…Seven cohort studies investigated the association between cyclizine or meclizine exposure and birth defects 13-19 . A Northern California Kaiser Permanente cohort study of 4,277 pregnancies between 1960-1964 included detailed maternal interviews to ascertain medication use in addition to validation from the prenatal record 18 .…”

Section: Resultsmentioning

confidence: 99%

“…Three analyses of Swedish data explored meclizine in relation to birth defects 13, 14, 19 . The earliest included 5,753 women, 778 of whom used an antiemetic (i.e.…”

Section: Resultsmentioning

confidence: 99%

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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“…The second study, from Sweden, was a cohort study examining data from the Swedish Medical Birth Registry (15). A total of 65 women were exposed to ondansetron during pregnancy.…”

Section: Initial Cohort Studiesmentioning

confidence: 99%

Ondansetron Use in Pregnancy and Birth Defects

Carstairs

2016

Obstetrics &Amp; Gynecology

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Use of antiemetic drugs during pregnancy in Sweden

Cited by 75 publications

References 15 publications

Maternal Use of Antipsychotics in Early Pregnancy and Delivery Outcome

Maternal Use of Antipsychotics in Early Pregnancy and Delivery Outcome

Antihistamines and birth defects: a systematic review of the literature

Ondansetron Use in Pregnancy and Birth Defects

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