Findings on potential teratogens from a case-control study in Western Australia.
OBJECTIVE
To examine, in Western Australian women, pregnancy use of drugs that have been found to be associated with birth defect risks in other studies.


METHODS
Data were used from a retrospective study of birth defects in which mothers were sent questionnaires asking about a variety of pregnancy events and exposures, including specific questions on medication use.


METHODS
Case subjects were fetuses or infants with structural birth defects born in Western Australia from 1997 to 2000, identified from the Western Australian Birth Defects Registry. Control subjects were infants without birth defects, randomly selected from the Western Australian Midwives' Notification System.


METHODS
First trimester uses of corticosteroids, medications that antagonise folic acid metabolism, and vasoactive drugs were compared between case and control mothers.


RESULTS
The mothers of 2.5, 2.4, and 1.9% of controls, cases, and oral cleft cases, respectively, reported corticosteroid use. The mothers of 0.6% of controls and 1.4% of cases used a folic acid antagonising medication, yielding an odds ratio of 2.3 (95% confidence interval, 0.58-9.4). The mothers of 4.5% of controls and 7.1% of cases used a vasoactive drug (pseudoephedrine, aspirin, ibuprofen, amphetamine, cocaine, or ecstasy). Cigarette smoking is also vasoactive. For exposure to both a vasoactive drug and cigarette smoking, the birth defect risk was 3.0 (0.92-9.6).


CONCLUSIONS
There was no difference in corticosteroid use between case and control mothers, although the number of exposed subjects was small. Odds ratio estimates for folic acid antagonists and vasoactive agents support previously reported associations, but they were not statistically significant.
Werler
Martha M
MM
Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia. mwerler@slone.bu.edu
Bower
Carol
C
Payne
Jan
J
Serna
Peta
P
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology* / Q000209:etiology*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005493:Folic Acid Antagonists / Q000009:adverse effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012042:Registries; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013723:Teratogens; D014904:Western Australia / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D005493:Folic Acid Antagonists; D013287:Illicit Drugs; D013723:Teratogens