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First trimester maternal medication use in relation to gastroschisis
M M Werler1, A A Mitchell, S Shapiro
1Slone Epidemiology Unit, Boston University School of Public Health, Brookline, Massachusetts 02146.
Teratology
|April 1, 1992
Summary
First trimester use of pseudoephedrine was linked to a higher risk of gastroschisis in infants. This study also explored other medications, suggesting potential links between maternal drug use and birth defects.
Area of Science:
- Perinatal epidemiology
- Teratology
- Public health
Background:
- Gastroschisis is a major congenital malformation with multifactorial etiology.
- Understanding the role of early pregnancy exposures, particularly medications, is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between first-trimester medication use and the risk of gastroschisis.
- To explore the hypothesis that vasoactive medications may contribute to gastroschisis through vascular disruption.
Main Methods:
- A case-control study comparing 76 gastroschisis cases with 2,142 controls with other major malformations.
- Multivariate analysis was used to adjust for confounding factors.
- A second analysis examined maternal use of vasoactive medications in relation to infants with heterogeneous defects suspected of vascular etiology.
Main Results:
- Pseudoephedrine use in the first trimester was associated with a significantly elevated relative risk of gastroschisis (RR=3.2).
- Tentative associations were observed for salicylates (RR=1.6) and acetaminophen (RR=1.7).
- No increased risks were found for antihistamines, antibiotics, oral contraceptives, or spermicides.
Conclusions:
- The findings suggest a potential association between pseudoephedrine and gastroschisis, supporting the vascular disruption hypothesis.
- The association with acetaminophen may indicate confounding by maternal illness.
- Further independent studies are needed to confirm these tentative associations.