title: Use of oral contraceptives in pregnancy and major structural birth defects in offspring.
abstract: BACKGROUND
  Oral contraceptives (OCs) are the most commonly used reversible contraceptive method among US women. Although the majority of previous studies have reported no association between OC use during pregnancy and birth defects, some studies have reported increased occurrence of neural tube defects, limb reduction defects, and urinary tract anomalies.
  
  
  METHODS
  We assessed OC use among mothers who participated in the multisite, case-control, National Birth Defects Prevention Study. Mothers of 9986 infants with 32 types of birth defects and 4000 infants without birth defects were included.
  
  
  RESULTS
  Maternal OC use during the first 3 months of pregnancy was associated with an increased odds ratio for 2 of 32 birth defects: hypoplastic left heart syndrome (adjusted odds ratio = 2.3 [95% confidence interval = 1.3-4.3) and gastroschisis (1.8 [1.3-2.7]).
  
  
  CONCLUSIONS
  Previous reports of associations between OC use and specific types of anomalies were not corroborated. Given that associations were assessed for 32 types of birth defects, our findings of 2 increased associations between OC use and gastroschisis and hypoplastic left heart syndrome should be interpreted as hypotheses until they can be evaluated further. Overall, our findings are consistent with the majority of previous studies that found women who use OCs during early pregnancy have no increased risk for most types of major congenital malformations.
authors.affiliation: The University of Texas, Houston Health Science Center, School of Public Health, Houston, TX 77030, USA. Kim.Waller@uth.tmc.edu
authors.forename: Dorothy Kim
authors.initials: DK
authors.lastname: Waller
authors.forename: Michael Shayne
authors.initials: MS
authors.lastname: Gallaway
authors.forename: Lockwood G
authors.initials: LG
authors.lastname: Taylor
authors.forename: Tunu A
authors.initials: TA
authors.lastname: Ramadhani
authors.forename: Mark A
authors.initials: MA
authors.lastname: Canfield
authors.forename: Angela
authors.initials: A
authors.lastname: Scheuerle
authors.forename: Sonia
authors.initials: S
authors.lastname: Hernández-Diaz
authors.forename: Carol
authors.initials: C
authors.lastname: Louik
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology / Q000209:etiology*; D000015:Abnormalities, Multiple / Q000139:chemically induced / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D016001:Confidence Intervals; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology; D003276:Contraceptives, Oral / Q000009:adverse effects*; D005260:Female; D020139:Gastroschisis / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000139:chemically induced / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014551:Urinary Tract / Q000002:abnormalities; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral