title: No association between severe constipation with related drug treatment in pregnant women and congenital abnormalities in their offspring: A population-based case-control study.
abstract: Constipation is a common pathological condition in pregnant women; nevertheless, its possible association with structural birth defects (i.e. congenital abnormalities [CA]) in their offspring has not been studied in controlled epidemiological studies. We evaluated the possible association between severe constipation with laxative treatment in pregnant women and congenital abnormalities in their offspring. The dataset of the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities (HCCSCA) 1980-1996 contained 22 843 cases with CA and 38 151 matched controls without CA. Only pregnant women with prospectively and medically recorded constipation were included in the study and 13 CA groups were compared in cases and all their matched controls. A total of 78 (0.34%) cases had mothers with severe constipation and treatment during pregnancy compared to 144 (0.38%) controls (adjusted OR with 95% CI = 1.0, 0.7-1.3). Specified groups of CA were also assessed versus controls, but a higher occurrence of pregnant women with severe constipation and related treatment was not found in any CA group. Among laxative drugs, senna has no teratogenic potential; thus, if severe constipation requires laxative drug treatment in pregnant women, senna is not contraindicated. A higher rate of CA was not found in the offspring of pregnant women with severe constipation and related senna treatment.
authors.affiliation: Second Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
authors.forename: Nándor
authors.initials: N
authors.lastname: Acs
authors.forename: Ferenc
authors.initials: F
authors.lastname: Bánhidy
authors.forename: Erzsébet H
authors.initials: EH
authors.lastname: Puhó
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Czeizel
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology; D000328:Adult; D016022:Case-Control Studies; D003248:Constipation / Q000188:drug therapy*; D005260:Female; D006801:Humans; D054368:Laxatives / Q000009:adverse effects*; D020113:Phenolphthalein / Q000627:therapeutic use; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology; D012042:Registries; D012676:Senna Extract / Q000627:therapeutic use; D013723:Teratogens
chemical_list: D054368:Laxatives; D013723:Teratogens; D020113:Phenolphthalein; D012676:Senna Extract