title: Maternal asthma medication use during pregnancy and risk of congenital heart defects.
abstract: BACKGROUND
  Asthma affects 4% to 8% of pregnant women and studies suggest maternal asthma, particularly when uncontrolled, may be associated with adverse reproductive outcomes.
  
  
  METHODS
  We examined self-reported asthma medication use and the risk of congenital heart defects (CHD) in the National Birth Defects Prevention Study, a multi-center, population-based case-control study of selected major structural defects. We evaluated maternal use of bronchodilators and anti-inflammatories during the periconceptional period (1 month before conception through the first 3 pregnancy months) among 7638 infants with CHDs and 8106 nonmalformed controls with estimated delivery dates from 1997 to 2007. We used logistic regression to estimate odds ratios and 95% confidence intervals for 20 types of CHDs.
  
  
  RESULTS
  Among asthma medications reported during the periconceptional period among controls, albuterol accounted for 85.1% of all bronchodilator use, and fluticasone, prednisone, and montelukast accounted for 46.1%, 15.6%, and 14.9% of anti-inflammatory use, respectively. Of the women who reported bronchodilators during the periconceptional period, 71.1% reported use throughout pregnancy and only 29.4% reported concurrent use of an anti-inflammatory. We observed one statistically significant association between maternal bronchodilator use only and anomalous pulmonary venous return (odds ratio 2.3, 95% confidence interval 1.1-4.8) among numerous comparisons.
  
  
  CONCLUSIONS
  We did not observe statistically significant associations between the reported use of asthma medications during pregnancy and most specific types of CHDs. Despite limitations in our inability to evaluate asthma status and severity, our study suggests that maternal asthma medication use does not substantially, if at all, increase the risk of CHDs.
authors.affiliation: University at Albany School of Public Health, One University Place, Rensselaer, New York.|Bureau of Environmental & Occupational Epidemiology, New York State Department of Health, Empire State Plaza, Corning Tower, Albany, New York.
authors.forename: Alissa R
authors.initials: AR
authors.lastname: Van Zutphen
authors.affiliation: University at Albany School of Public Health, One University Place, Rensselaer, New York.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Bell
authors.affiliation: University at Albany School of Public Health, One University Place, Rensselaer, New York.|Bureau of Environmental & Occupational Epidemiology, New York State Department of Health, Empire State Plaza, Corning Tower, Albany, New York.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Browne
authors.affiliation: University at Albany School of Public Health, One University Place, Rensselaer, New York.|Bureau of Environmental & Occupational Epidemiology, New York State Department of Health, Empire State Plaza, Corning Tower, Albany, New York.
authors.forename: Shao
authors.initials: S
authors.lastname: Lin
authors.affiliation: Medical Genetics, MassGeneral Hospital for Children, Boston, Massachusetts.
authors.forename: Angela E
authors.initials: AE
authors.lastname: Lin
authors.affiliation: University at Albany School of Public Health, One University Place, Rensselaer, New York.|Bureau of Environmental & Occupational Epidemiology, New York State Department of Health, Empire State Plaza, Corning Tower, Albany, New York.
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Druschel
mesh_terms: D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D055815:Young Adult
chemical_list: D018926:Anti-Allergic Agents
keywords: asthma medications; birth defects; congenital heart defects