Maternal periconceptional illicit drug use and the risk of congenital malformations.
BACKGROUND
In 2004, the Survey on Drug Use and Health showed that 5% of American women reported use of an illicit drug during pregnancy. The results of studies determining the association between periconceptional illicit drug use and birth defects have been inconsistent.


METHODS
We analyzed data from the National Birth Defects Prevention Study, a case-control study of major birth defects, and assessed all birth defects categories in which there were at least 250 interviewed case mothers. We included 10,241 infants with major congenital malformations (case infants) and 4,967 infants without major congenital malformations (control infants) born between 1997 and 2003 for whom there was a completed maternal interview with detailed information on prenatal illicit drug use and potential confounders. We used multivariable logistic regression to estimate the associations between cannabis, cocaine, and stimulant use in the month before pregnancy or during the first trimester (periconceptional period) and the occurrence of selected birth defects.


RESULTS
In the periconceptional period, 5% of the 15,208 mothers reported any use of illicit drugs. We did not find associations between illicit drug use and most of the 20 eligible categories of congenital malformations. Periconceptional cannabis use seemed to be associated with an increased risk of anencephaly (adjusted odds ratio = 1.7; 95% confidence interval = 0.9-3.4), whereas cocaine use in the periconceptional period was associated with the risk of cleft palate (2.5; 1.1-5.4).


CONCLUSIONS
There were very few suggestions of positive associations between periconceptional illicit drug use and the 20 birth defects categories.
van Gelder
Marleen M H J
MM
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Reefhuis
Jennita
J
Caton
Alissa R
AR
Werler
Martha M
MM
Druschel
Charlotte M
CM
Roeleveld
Nel
N
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D019992:Databases as Topic; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D009035:Mothers; D011247:Pregnancy / Q000187:drug effects*; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000150:complications*; D014481:United States / Q000453:epidemiology; D055815:Young Adult