Maternal corticosteroid use and risk of selected congenital anomalies.
Evidence for the teratogenicity of corticosteroids in humans is limited and has resulted in inconsistent recommendations regarding their use during early pregnancy. We examined the association between women's corticosteroid use during the periconceptional period (1 month before to 3 months after conception) and delivering infants with selected congenital anomalies. Data were derived from a population-based case-control study that included cases of orafacial clefts (n = 662), conotruncal heart defects (n = 207), neural tube defects (n = 265), and limb reduction defects (n = 165). Information on medication use was collected via maternal telephone interviews. Corticosteroid use was associated with an increased risk for isolated cleft lip with or without cleft palate (odds ratio 4.3, 95% confidence interval 1.1-17.2) and isolated cleft palate (odds ratio 5.3, 95% confidence interval 1.1-26.5). Increased risks were not observed for the other anomaly groups studied. These data in conjunction with other epidemiologic data suggest a possible causal association between cleft lip and palate and corticosteroid use.
Carmichael
S L
SL
March of Dimes/California Birth Defects Monitoring Program, Emeryville, California 94608, USA. slc@a.crl.com
Shaw
G M
GM
D000014:Abnormalities, Drug-Induced / Q000209:etiology*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D016022:Case-Control Studies; D002971:Cleft Lip / Q000139:chemically induced; D002972:Cleft Palate / Q000139:chemically induced; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced; D006801:Humans; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital / Q000139:chemically induced; D008431:Maternal-Fetal Exchange; D009436:Neural Tube Defects / Q000139:chemically induced; D011247:Pregnancy; D012307:Risk Factors; D013723:Teratogens / Q000633:toxicity
D000305:Adrenal Cortex Hormones; D013723:Teratogens