Maternal panic disorder and congenital abnormalities: a population-based case-control study.
BACKGROUND
Maternal panic disorder in pregnancy is the most common manifestation of anxiety disorders in Hungary. The association between panic disorder during pregnancy and structural birth defects, i.e., congenital abnormalities, was studied.


METHODS
The prevalence of maternal panic disorder in cases with different congenital abnormalities was compared to that of matched controls in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities.


RESULTS
Of 22,843 cases with congenital abnormalities, 210 (0.9%) had mothers with panic disorder during pregnancy compared to 187 (0.5%) of 38,151 controls (adjusted prevalence odds ratio [POR] 1.6; 95% CI, 1.3-2.0). Specific groups of congenital abnormalities were also assessed versus controls. Cases with isolated cleft lip with or without cleft palate (CL/P) (adjusted POR, 3.4; 95% CI, 1.3-9.0) and multiple congenital abnormalities (adjusted POR, 3.0; 95% CI, 1.2-7.2) were more likely to have had mothers with panic disorder during the study pregnancy. Notably, among mothers with panic disorders, the associations were found only in offspring of untreated mothers.


CONCLUSIONS
A higher rate of isolated CL/P and multiple congenital abnormalities may be caused by the direct biological effect of panic disorder or by the interaction of maternal panic disorder and lifestyle factors. Antipanic drug treatment seems to have a protective effect for isolated CL/P and multiple congenital abnormalities. Birth Defects Research (Part A), 2006.
Acs
Nándor
N
Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary.
Bánhidy
Ferenc
F
Horváth-Puhó
Erzsébet
E
Czeizel
Andrew E
AE
D000015:Abnormalities, Multiple / Q000453:epidemiology; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D016584:Panic Disorder / Q000188:drug therapy / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence
D014151:Anti-Anxiety Agents