title: [Drugs use in pregnancy in the Valencia Region and the risk of congenital anomalies].
abstract: BACKGROUND
  Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades.
  
  
  OBJECTIVE
  To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women residents in the Valencia Region.
  
  
  METHODS
  A case-control study, considering a case as a less than one year old live birth in 2009-2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry. Controls were selected from the Metabolic Disease Registry, and the drugs prescribed and dispensed from the Integral Management of Pharmaceutical Services. Crude odds ratio (OR) was calculated with its 95% confidence intervals and adjusted OR was calculated using logistic regression.
  
  
  RESULTS
  A total of 1,913 cases and 3,826 controls were identified. The most frequently used drug groups were those acting on the musculoskeletal, nervous and respiratory systems, on the blood and blood forming organs, and anti-infection drugs. The most common drugs used were ibuprofen, dexketoprofen, paracetamol, amoxicillin, ferrous sulphate, and a combination of folic acid. A significantly increased risk of CA was identified for drugs acting on the musculoskeletal system (adjusted OR 1.14 [95% confidence interval 1.02-1.28]). A significantly decreased risk was observed for drugs acting on the blood and blood forming organs (adjusted OR 0.87 [95% confidence interval 0.78-0.98]).
  
  
  CONCLUSIONS
  Associations between drugs and CA in pregnant women resident in the Valencia Region have been identified for drugs that act as risk factors of CA, and for drugs that act as protective factors of CA.
authors.affiliation: Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Universitat de València Estudi General, Valencia, España.
authors.forename: Clara
authors.initials: C
authors.lastname: Cavero-Carbonell
authors.affiliation: Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Universitat de València Estudi General, Valencia, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España. Electronic address: gimeno_silmar@gva.es.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gimeno-Martos
authors.affiliation: Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Universitat de València Estudi General, Valencia, España.
authors.forename: Lucía
authors.initials: L
authors.lastname: Páramo-Rodríguez
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Rabanaque-Hernández
authors.affiliation: Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Universitat de València Estudi General, Valencia, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martos-Jiménez
authors.affiliation: Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Universitat de València Estudi General, Valencia, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España; Conselleria de Sanitat Universal i Salut Pública, Valencia, España.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Zurriaga
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology*; D000328:Adult; D000553:Ambulatory Care; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Anomalías congénitas; Comunitat Valenciana; Congenital abnormalities; Embarazo; Factores de riesgo; Pharmaceutical preparations; Pregnancy; Preparación farmacéutica; Risk factors; Valencia Region