title: Decongestant use during pregnancy and its association with preterm delivery.
abstract: BACKGROUND
  Despite the frequent intake of decongestants during pregnancy, only one study to date has evaluated the association of decongestants with preterm delivery, and it identified a reduced risk. We examined this association in more detail.
  
  
  METHODS
  Using a population-based random sample of 3271 Massachusetts live-born births without major malformations, we categorized decongestant exposure according to timing, frequency of use, route, and indication. Preterm birth was defined as a gestational age of <37 completed weeks. We estimated hazard ratios and examined confounding by indication by examining various strata of women and through multivariate adjustment.
  
  
  RESULTS
  Compared to nonexposed women, those who took decongestants during the second or third trimester only were less likely to experience preterm delivery (HR, 0.42; 95% CI, 0.21-0.84). This association was observed only for women without preeclampsia.
  
  
  CONCLUSIONS
  A protective association between decongestant use and preterm delivery has now been observed in two studies; however, the possibility of confounding by underlying condition remains.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts 02118, USA. rohinikh@bu.edu
authors.forename: Rohini K
authors.initials: RK
authors.lastname: Hernandez
authors.forename: Allen A
authors.initials: AA
authors.lastname: Mitchell
authors.forename: Martha M
authors.initials: MM
authors.lastname: Werler
mesh_terms: D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D008404:Massachusetts; D014663:Nasal Decongestants / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature; D036801:Parturition / Q000187:drug effects*; D010665:Phenylpropanolamine / Q000627:therapeutic use; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D054199:Pseudoephedrine / Q000627:therapeutic use; D012189:Retrospective Studies; D012220:Rhinitis / Q000188:drug therapy*; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D014663:Nasal Decongestants; D010665:Phenylpropanolamine; D054199:Pseudoephedrine