Vaginal spermicides, chromosomal abnormalities and limb reduction defects

Each year, 300,000-600,000 U.S. women become pregnant while using vaginal spermicides. Two recent reports hypothesized that offspring from these pregnancies are at increased risk of certain birth defects, particularly limb reduction defects and such chromosomal abnormalities as Down syndrome. In a case-control analysis of data from the Metropolitan Atlanta Congenital Defects Program (MACDP), we studied the teratogenicity of spermicides by comparing their use around the time of conception by mothers of infants with chromosomal abnormalities and limb reduction defects to their use by mothers of infants with birth defects that have not been linked to spermicides. The results do not support the hypothesis that spermicides are teratogenic. For infants whose mothers used spermicides at the time of conception, the relative risk of having Down syndrome was 1.2 and that for other chromosomal abnormalities was also 1.2. The relative risk of limb reduction defects among infants exposed to spermicides in the first trimester was 1.0. None of these risks is statistically significant.