title: Case-control analysis of maternal prenatal analgesic use and cardiovascular malformations: Baltimore-Washington Infant Study.
abstract: OBJECTIVE
  We sought to assess maternal prenatal use of analgesics and risk of cardiovascular malformations (CVM) in the offspring.
  
  
  METHODS
  Data from the Baltimore-Washington Infant Study, a population-based case-control investigation of CVM, were used to examine selected isolated CVM diagnoses and maternal analgesic use during the periconceptional period (3 months before and after conception). We compared case and control infants on frequency of maternal use of analgesics and estimated adjusted odds ratios (adjORs) and 95% confidence intervals (CI) with logistic regression models for specific CVM phenotypes.
  
  
  RESULTS
  Frequency of periconceptional use of any analgesic was 52% among control mothers and 53% among case mothers. Analyses by CVM diagnoses identified an association of tetralogy of Fallot with maternal acetaminophen use (adjOR, 1.6; 95% CI, 1.1-2.3) and dextrotransposition of the great arteries with intact ventricular septum with maternal nonsteroidal antiinflammatory drug use (adjOR, 3.2; 95% CI, 1.2-8.7).
  
  
  CONCLUSIONS
  Analgesic use during the periconceptional period was not associated with CVM in the aggregate or with most phenotypes of CVM examined. Associations with 2 phenotypes of CVM may have occurred by chance. These findings warrant corroboration and further study, including further evaluation of the observed associations, the dose of analgesic taken, more specific timing of analgesic use, and indications for use.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS. Electronic address: cmarsh2@kumc.edu.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Marsh
authors.affiliation: National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), Atlanta, GA.
authors.forename: Janet D
authors.initials: JD
authors.lastname: Cragan
authors.affiliation: National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), Atlanta, GA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Alverson
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
mesh_terms: D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D018376:Cardiovascular Abnormalities / Q000139:chemically induced*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D016015:Logistic Models; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics
keywords: analgesics; birth defects; cardiovascular malformations; congenital heart defects; pregnancy