Preliminary results were presented at the annual meeting of the Centers for Birth Defects Research and Prevention (San Antonio, TX; November 11, 2004) and at the annual Maternal and Child Health Epidemiology Conference (Atlanta, GA; December 7, 2006).
Article first published online: 19 NOV 2011
Copyright © 2011 Wiley Periodicals, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 94, Issue 1, pages 22–30, January 2012
How to Cite
Anderka, M., Mitchell, A. A., Louik, C., Werler, M. M., Hernández-Diaz, S., Rasmussen, S. A. and the National Birth Defects Prevention Study (2012), Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects. Birth Defects Research Part A: Clinical and Molecular Teratology, 94: 22–30. doi: 10.1002/bdra.22865
This study was supported by a grant from the Centers for Disease Control and Prevention (U50/CCU 113247), by a New Investigator in MCH Research Dissertation Award from MCHB, HHS (1 R03 MC 00004); and by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (RO1 HD 046595). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the Massachusetts Department of Public Health.
- Issue published online: 10 JAN 2012
- Article first published online: 19 NOV 2011
- Manuscript Accepted: 30 AUG 2011
- Manuscript Revised: 27 AUG 2011
- Manuscript Received: 18 JUL 2011
- Centers for Disease Control and Prevention. Grant Number: U50/CCU 113247
- New Investigator in MCH Research Dissertation Award from MCHB. Grant Number: HHS (1 R03 MC 00004)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development. Grant Number: RO1 HD 046595
- National Birth Defects Prevention Study;
- nausea and vomiting of pregnancy;
- neural tube defects;
- orofacial clefts
BACKGROUND Nausea and vomiting of pregnancy (NVP) occurs in up to 80% of pregnant women, but its association with birth outcomes is not clear. Several medications are used for the treatment of NVP; however, data are limited on their possible associations with birth defects. METHODS Using data from the National Birth Defects Prevention Study (NBDPS)—a multi-site, population-based, case-control study—we examined whether NVP or its treatment was associated with the most common noncardiac defects in the NBDPS (nonsyndromic cleft lip with or without cleft palate [CL/P], cleft palate alone [CP], neural tube defects, and hypospadias) compared with randomly selected nonmalformed live births. RESULTS Among the 4524 cases and 5859 controls included in this study, 67.1% reported first-trimester NVP, and 15.4% of them reported using at least one agent for NVP. Nausea and vomiting of pregnancy was not associated with CP or neural tube defects, but modest risk reductions were observed for CL/P (adjusted odds ratio [aOR] = 0.87; 95% confidence interval [CI], 0.77–0.98) and hypospadias (aOR = 0.84; 95% CI, 0.72–0.98). Regarding treatments for NVP in the first trimester, the following adjusted associations were observed with an increased risk: proton pump inhibitors and hypospadias (aOR = 4.36; 95% CI, 1.21–15.81), steroids and hypospadias (aOR = 2.87; 95% CI, 1.03–7.97), and ondansetron and CP (aOR = 2.37; 95% CI, 1.18–4.76), whereas antacids were associated with a reduced risk for CL/P (aOR = 0.58; 95% CI, 0.38–0.89). CONCLUSIONS NVP was not observed to be associated with an increased risk of birth defects; however, possible risks related to three treatments (i.e., proton pump inhibitors, steroids and ondansetron), which could be chance findings, warrant further investigation. Birth Defects Research (Part A) 2012. © 2011 Wiley Periodicals, Inc.