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The Impact of Oral Intake of Dydrogesterone on Fetal Heart Development During Early Pregnancy
Mahmoud Zaqout1, Emad Aslem2, Mazen Abuqamar3
1Department of Pediatric Cardiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. dr_mahmoud9@hotmail.com.
Insights
Maternal dydrogesterone use in early pregnancy is linked to a higher risk of congenital heart disease in newborns. This study found an association, suggesting a potential preventable risk factor for these common birth defects.
Area of Science:
- Cardiology
- Obstetrics
- Teratology
Background:
- Congenital heart disease (CHD) is a leading cause of infant mortality and morbidity worldwide.
- Genetic factors explain less than 20% of CHD cases, highlighting the importance of identifying environmental and drug-related risk factors.
- Investigating preventable causes of CHD is crucial for public health, especially concerning medications used during pregnancy.
Purpose of the Study:
- To investigate the potential association between maternal dydrogesterone treatment during the first trimester of pregnancy and the occurrence of congenital heart disease in offspring.
- To determine if dydrogesterone exposure represents a modifiable risk factor for CHD.
Main Methods:
- A retrospective case-control study was conducted comparing 202 infants with CHD to 200 control infants born between 2010 and 2013.
- Dydrogesterone exposure was defined as use during the first trimester; exclusions included chromosomal abnormalities and maternal chronic illnesses.
- Binary logistic regression analysis was employed to assess the relationship between dydrogesterone exposure and CHD.
Main Results:
- Mothers of infants with CHD reported significantly higher dydrogesterone use in the first trimester compared to the control group.
- An adjusted odds ratio of 2.71 (95% CI 1.54-4.24, P=0.001) indicated a positive association between dydrogesterone exposure and CHD.
- The study identified a statistically significant link between early pregnancy dydrogesterone use and congenital heart defects in newborns.
Conclusions:
- Maternal dydrogesterone use in early pregnancy is associated with an increased risk of congenital heart disease in infants.
- This finding suggests dydrogesterone may be a preventable risk factor for CHD.
- Further research is warranted to confirm these findings and elucidate the underlying mechanisms.
Abstract:
Congenital heart disease is the most frequent form of congenital anomaly in newborn infants and accounts for more than a quarter of all serious congenital afflictions worldwide. A genetic etiology is identified in <20 % of cases of congenital heart defects, and in most cases the etiology remains a mystery. In the context of the health burden caused by congenital heart disease, the contribution of non-inherited risk factors is important especially if it turns out to be caused by a drug which can be avoided during pregnancy. We sought to determine whether maternal dydrogesterone treatment in early pregnancy is associated with congenital heart disease in the infant. We conducted a retrospective case-control study of birth defects and associated risk factors. Data were obtained and compared between 202 children born with congenital heart disease and a control group consisting of 200 children. All children were born in the period of 2010-2013. Dydrogesterone exposure was defined as any reported use during the first trimester of pregnancy. Exclusion criteria included stillbirths, children with chromosomal abnormalities and infants of mothers with chronic medical illnesses, e.g., diabetes. Binary logistic regression analyses were used to analyze the data and attempt to identify a causal relationship between drug exposure and congenital heart disease. Mothers of children born with congenital heart disease received more dydrogesterone during first trimester of pregnancy than mothers of children in the control group [adjusted odds ratio 2.71; (95 % CI 1.54-4.24); P = 0.001]. We identified a positive association between dydrogesterone usage during early pregnancy and congenital heart disease in the offspring. Nevertheless, further studies are needed to confirm these results.
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