A population-based case control study of congenital abnormalities and medication use during pregnancy using the Czech National Register of congenital abnormalities

• Authors: Jana Mašková , Antonín Šípek , Peter Kollár
• Languages of publication: EN

Abstracts

EN

The aim was to identify and quantify the association between the use of particular medications during the first trimester of pregnancy and selected congenital abnormalities (CAs) of newborns. Data were from the Czech National Registry of CAs. We used a case-control design, and collected total of 7285 cases and 9143 controls. Thiethylperazine and iron compounds had no effect on development of CAs. Lower odds ratio and potentially protective associations were found between CAs and bioflavonoids, folic acid, progesterone, levothyroxine, and iodine therapy. Since the protective effect of bioflavonoids was not described before, analysis of interaction with other drugs was performed. However, their protective effect was not confirmed and the strongest significant protective effect was detected in combination of bioflavonoids and progesterone. Increased odds ratio were identified for hydroxyprogesterone, phenoxymethylpenicillin, aspirin, paracetamol and valproic acid. The association between paracetamol and congenital foot deformities was not significant, while the same association for the whole group of CAs and deformities of musculoskeletal system had significantly increased odds ratio. Except newly described effect of bioflavonoids, our results are in agreement with risk categories defined by health authorities in USA and Australia, and with results of other studies. According to our results, paracetamol does not influence development of congenital foot deformities.

Keywords

EN

Bioflavonoids; Congenital abnormalities; Drug use; Pregnancy; Teratology

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2011
• Volume: 6
• Issue: 4
• Pages: 435-441

Dates

published

1 - 8 - 2011

online

1 - 6 - 2011

Contributors

author

Jana Mašková

• Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Palackého 1-3, CZ-612 42, Brno, Czech Republic

author

Antonín Šípek

• Department of Medical Genetics, Thomayer University Hospital, Vídeňská 800, CZ-140 59, Prague, Czech Republic

author

Peter Kollár

• Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Palackého 1-3, CZ-612 42, Brno, Czech Republic

References

• [1] Moore K.L., Persaud T.V.N., The developing human: clinically oriented embryology, 8th ed., PA: Saunders/Elsevier, Philadelphia, 2008
• [2] Polifka J.E., Friedman J.M., Clinical teratology: identifying teratogenic risks in humans, Clin Genet 1999, 56, 409–420 http://dx.doi.org/10.1034/j.1399-0004.1999.560601.x[Crossref]
• [3] Briggs G.G., Freeman R.K., Yaffe S.J., Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk, 5th ed., Lippincott Williams & Wilkins, Philadelphia, 1998
• [4] Bánhidy F., Lowry R.B., Czeizel A.E., Risk and benefit of drug use during pregnancy, Int J Med Sci., 2005, 2, 100–106 [PubMed][Crossref]
• [5] Brent R.L., Environmental causes of human congenital malformations: the pediatrician’s role in dealing with these complex clinical problems caused by a multiplicity of environmental and genetic factors, Pediatrics, 2004, 113, 957–968
• [6] Polifka J.E., Friedman J.M., Medical genetics: 1. Clinical teratology in the age of genomics, CMAJ, 2002, 167, 265–273
• [7] Daïkha-Dahmane F., Levy-Beff E., Jugie M., Lenclen R., Foetal kidney maldevelopment in maternal use of angiotensin II type I receptor antagonists, Pediatr Nephrol, 2006, 21, 729–732 http://dx.doi.org/10.1007/s00467-006-0070-1[Crossref]
• [8] Chen Y., Lasaitiene D., Friberg P., The renin-angiotensin system in kidney development, Acta Physiol Scand, 2004, 181, 529–535 http://dx.doi.org/10.1111/j.1365-201X.2004.01327.x[Crossref]
• [9] Pope J.C., Brock J.W., Adams M.C., Stephens F.D., Ichikawa I., How they begin and how they end: classic and new theories for the development and deterioration of congenital anomalies of the kidney and urinary tract, CAKUT, J Am Soc Nephrol, 1999, 10, 2018–2028 [PubMed]
• [10] Holmes L.B., Teratogen-induced limb defects, Am J Med Genet, 2002, 112, 297–303 http://dx.doi.org/10.1002/ajmg.10781[Crossref]
• [11] Krogsgaard M.R., Jensen P.K., Kjaer I., Husted H., Lorentzen J., Hvass-Christensen B., et al., Increasing incidence of club foot with higher population density: incidence and geographical variation in Denmark over a 16-year period-an epidemiological study of 936,525 births, Acta Orthop, 2006, 77, 839–846 http://dx.doi.org/10.1080/17453670610013114[Crossref]
• [12] Alderman B.W., Takahashi E.R., LeMier M.K., Risk indicators for talipes equinovarus in Washington State, 1987–1989, Epidemiology, 1991, 2, 289–292 http://dx.doi.org/10.1097/00001648-199107000-00009[Crossref]
• [13] Talamillo A., Bastida M.F., Fernandez-Teran M., Ros M.A., The developing limb and the control of the number of digits, Clin Genet, 2005, 67, 143–153 http://dx.doi.org/10.1111/j.1399-0004.2005.00404.x[Crossref]
• [14] Kazy Z., Puhó E., Czeizel A.E., The possible association between the combination of vaginal metronidazole and miconazole treatment and poly-syndactyly Population-based case-control teratologic study, Reprod Toxicol, 2005, 20, 89–94 http://dx.doi.org/10.1016/j.reprotox.2004.11.012[Crossref]

Identifiers

DOI

10.2478/s11536-011-0039-8