First-trimester antihistamine exposure and risk of spontaneous abortion or preterm birth

Authors

  • Tiara D. Aldridge,

    1. Vanderbilt Epidemiology Center, Nashville, TN, USA
    2. Vanderbilt University, Institute of Medicine and Public Health, Nashville, TN, USA
    3. Vanderbilt University, Department of Obstetrics and Gynecology, Nashville, TN, USA
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  • Katherine E. Hartmann,

    1. Vanderbilt Epidemiology Center, Nashville, TN, USA
    2. Vanderbilt University, Institute of Medicine and Public Health, Nashville, TN, USA
    3. Vanderbilt University, Department of Obstetrics and Gynecology, Nashville, TN, USA
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  • Kara A. Michels,

    1. Vanderbilt Epidemiology Center, Nashville, TN, USA
    2. Vanderbilt University, Institute of Medicine and Public Health, Nashville, TN, USA
    3. Vanderbilt University, Department of Obstetrics and Gynecology, Nashville, TN, USA
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  • Digna R. Velez Edwards

    Corresponding author
    1. Vanderbilt Epidemiology Center, Nashville, TN, USA
    2. Vanderbilt University, Institute of Medicine and Public Health, Nashville, TN, USA
    3. Vanderbilt University, Department of Obstetrics and Gynecology, Nashville, TN, USA
    4. Center for Human Genetics Research, Vanderbilt University, Nashville, TN, USA
    • Correspondence to: D. R. Velez Edwards, Vanderbilt Epidemiology Center, 2525 West End Ave., Suite 600 6th Floor, Nashville, TN 37203, USA. E-mail: digna.r.velez.edwards@vanderbilt.edu

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  • Prior presentations: Preliminary results from these analyses were presented at the Vanderbilt University Emphasis Research Forum (poster, April 2012) and at the Vanderbilt Medical Alumni Association (plenary session, October of 2012).

ABSTRACT

Purpose

We tested whether antihistamine exposure during early pregnancy is associated with spontaneous abortion (SAB) or preterm birth (PTB).

Methods

Women were enrolled in Right from the Start (2004–2010), a prospective pregnancy cohort. Data about first-trimester antihistamine use were obtained from screening and first-trimester interviews. Self-reported outcomes included SAB and PTB and were verified by medical records. Cox proportional hazards models were used to test for an association between antihistamine use and each outcome, both performed adjusting for confounders.

Results

Among the 2685 pregnancies analyzed, 14% (n = 377) reported use of antihistamines. Among antihistamine users, 12% (n = 44) experienced SABs, and 6% (n = 21) had PTBs. Antihistamine exposure was not associated with SAB (adjusted hazard ratio [aHR] = 0.88, 95% confidence interval [CI] 0.64, 1.21) or PTB, which was modified by maternal race (aHR = 1.03, 95%CI 0.61, 1.72 among White women and aHR = 0.43, 95%CI 0.14, 1.34 among Black women).

Conclusions

Despite the biologic plausibility that antihistamine use may influence pregnancy outcomes, we did not detect evidence of an association with SAB or PTB. These data demonstrate the utility of large prospective cohorts for evaluating drug safety in pregnancy when concerns are raised from animal models. Copyright © 2014 John Wiley & Sons, Ltd.

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