Use of antihistamine medications during early pregnancy and isolated major malformations

Authors

  • Suzanne M. Gilboa,

    Corresponding author
    1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mail Stop E-86, 1600 Clifton Rd., Atlanta, GA 30333
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  • Matthew J. Strickland,

    1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Andrew F. Olshan,

    1. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Martha M. Werler,

    1. Slone Epidemiology Center at Boston University, Boston, Massachusetts
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  • Adolfo Correa

    1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Presented at the 20th annual meeting of the Society for Pediatric and Perinatal Epidemiologic Research, June 18–19, 2007, Boston, MA and the 40th annual meeting of the Society for Epidemiologic Research, June 19–24, 2007, Boston, MA.

  • Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Abstract

BACKGROUND:

Antihistamines are commonly used during pregnancy. There is little evidence that they have teratogenic effects, but there are knowledge gaps with respect to newer products, as well as the relationship between specific antihistamines and specific birth defects.

METHODS:

Using the National Birth Defects Prevention Study (1997–2003), the authors examined associations between maternal use of 14 antihistamines during early pregnancy and 26 isolated major birth defects. A Bayesian analysis incorporating prior knowledge about the relationships between antihistamines, birth defects, and measured covariates was conducted.

RESULTS:

Of the 364 associations investigated, 24 had 95% posterior intervals excluding 1.0. All 24 associations were positive; 23 associations were of weak to moderate magnitude (posterior OR < 3.0) and one was strong (OR > 6.0) but very imprecise. Of the 24 associations, 20 were with noncardiac defects. Eight associations involved the antihistamine diphenhydramine.

CONCLUSIONS:

The results of this study generally were consistent with no association between birth defects and antihistamine use during early pregnancy. Several of the findings might warrant further investigation, although the observed elevated associations should be interpreted in the context of the number of associations investigated and the analysis of retrospective, self-reported data. Birth Defects Research (Part A) 2009. © 2009 Wiley-Liss, Inc.

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