Get access

Beta2-agonists use during pregnancy and the risk of congenital malformations

Authors

  • Sherif Eltonsy,

    1. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
    2. Hopital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
    Search for more papers by this author
  • Amélie Forget,

    1. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
    2. Hopital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
    Search for more papers by this author
  • Lucie Blais

    Corresponding author
    1. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
    2. Hopital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
    • Université de Montréal, Faculté de pharmacie, C.P., 6128, succursale Centre-ville, Montréal, Québec H3C 3J7, Canada
    Search for more papers by this author
    • Tel.: (514) 343-6111 extension 1-3786, Fax: (514) 343-6120


  • Disclosure of potential conflict of interest: L. Blais has received research support from AstraZeneca, Amgen, and GlaxoSmithKline. S. Eltonsy has declared that he has no conflict of interest. A. Forget has declared that she has no conflict of interest.

  • L. Blais is the recipient of a Salary Award from the Fonds de la recherché en santé du Québec (FRSQ) and is the Endowment Pharmaceutical Chair AstraZeneca in Respiratory Health. This study was funded through grants received from the Fonds de la recherche en santé du Québec (FRSQ), and the Canadian Institutes of Health Research (CIHR).

Abstract

BACKGROUND

Treatment of asthma symptoms during pregnancy is crucial for maternal and fetal health. Short-acting beta2-agonists (SABA) are frequently used as rescue medications and long-acting beta2-agonists (LABA) are used as add-on controller therapy for asthma during pregnancy.

OBJECTIVE

The objective of this study was to investigate the association between exposure to SABA and LABA in the first trimester of pregnancy and the risk of congenital malformations among women with asthma.

METHODS

A cohort of pregnancies from women with asthma was formed through linkage of three administrative databases from Québec, Canada. The primary outcomes were major and any congenital malformations. The primary exposures were exposure to SABA and LABA during the first trimester, while secondary exposure was weekly SABA doses. The associations between congenital malformations (any, major, and specific) and SABA and LABA exposure were assessed with generalized estimating equations models.

RESULTS

From a group of 13,117 pregnancies, we identified 1242 and 762 infants with any (9.5%) and major (5.8%) congenital malformations, respectively. The adjusted odds ratios (95% confidence interval [CI]) for any malformations associated with the use of SABA and LABA were 1.04 (95% CI, 0.92–1.17) and 1.37 (95% CI, 0.92–2.17), respectively. The corresponding figures were 0.93 (95% CI, 0.80–1.08) and 1.31 (95% CI, 0.74–2.31) for major malformations. Significant increased risks of major “cardiac” and major “other and unspecified” congenital malformations were observed with LABA use.

CONCLUSION

Our study supports the evidence of SABA safety during pregnancy, but more research is required to assess whether the increased risk of malformations among LABA users is due to the medication, bias by asthma severity, or chance alone. Birth Defects Research (Part A) 2011. © 2011 Wiley-Liss, Inc.

Get access to the full text of this article

Ancillary