The Ribavirin Pregnancy Registry: Findings after 5 years of enrollment, 2003-2009.
BACKGROUND
Ribavirin, with interferons or pegylated interferons, is used to treat chronic hepatitis C. Ribavirin is contraindicated in pregnancy (FDA Pregnancy Category X) and in men whose partners may become pregnant. In 2003, the Ribavirin Pregnancy Registry was established to monitor pregnancy exposures to ribavirin and to evaluate the potential human teratogenicity of prenatal exposure.


METHODS
This voluntary registry enrolls pregnant women who have been exposed to ribavirin during pregnancy or during the six months prior to conception either directly, by taking ribavirin, or indirectly through sexual contact with a man taking ribavirin. Women are followed until delivery; live born infants are followed for one year. The Registry aims to enroll 131 live births following direct (maternal) exposure to ribavirin and 131 live births following indirect (male) exposures.


RESULTS
After more than five years of operation, the Registry has enrolled 49 live births with direct exposure and 69 live births following indirect exposure. Six outcomes with birth defects have been reported. All were among live born infants: torticollis (2), hypospadias (1), polydactyly and a neonatal tooth (1), glucose-6-phosphate dehydrogenase deficiency (1), ventricular septal defect and cyst of 4th ventricle of the brain (1). Three received direct exposures ([6.1% (95% CI: 1.2, 16.9)], three were exposed indirectly [4.3% (95% CI: 0.9, 12.2)].


CONCLUSIONS
Although current enrollment is far short of the required sample size, preliminary findings have not detected a signal indicating human teratogenicity for ribavirin. However, findings must be interpreted with caution concerning direct or indirect prenatal ribavirin exposures.
Roberts
Susan S
SS
University of North Carolina-Wilmington, 28403-5995, USA. Robertss@uncw.edu
Miller
Richard K
RK
Jones
Judith K
JK
Lindsay
Karen L
KL
Greene
Michael F
MF
Maddrey
Willis C
WC
Williams
Ian T
IT
Liu
John
J
Spiegel
Robert J
RJ
D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries / Q000706:statistics & numerical data*; D012254:Ribavirin / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
D012254:Ribavirin