Gastroschisis and pseudoephedrine during pregnancy

(1) Gastroschisis is a severe defect in the closure of the abdominal wall in newborns. The incidence seems to be increasing. (2) Three case-control studies have examined pseudoephedrine exposure among mothers of children born with gastroschisis. The evidence is weak but consistent. In two studies, pseudoephedrine exposure was associated with a significant odds ratio. In the most recent study, the risk of gastroschisis was increased 4.2-fold among women taking the pseudoephedrine-paracetamol combination (95% confidence interval 1.9-9.2). Paracetamol is not known to cause this malformation. (3) Pseudoephedrine is a sympathomimetic vasoconstrictor contained in many over-the-counter oral decongestants sold in France. (4) In practice, it is best to avoid prescribing, dispensing or using preparations containing pseudoephedrine during pregnancy.