Use of asthma medication during pregnancy and risk of specific congenital anomalies: A European case-malformed control study.

Details

Serval ID
serval:BIB_A32A433798B8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of asthma medication during pregnancy and risk of specific congenital anomalies: A European case-malformed control study.
Journal
Journal of Allergy and Clinical Immunology
Author(s)
Garne E., Hansen A.V., Morris J., Zaupper L., Addor M.C., Barisic I., Gatt M., Lelong N., Klungsøyr K., O'Mahony M., Nelen V., Neville A.J., Pierini A., Tucker D., de Walle H., Wiesel A., Loane M., Dolk H.
ISSN
1097-6825 (Electronic)
ISSN-L
0091-6749
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
136
Number
6
Pages
1496-502.e1-7
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Pregnant women with asthma need to take medication during pregnancy.
OBJECTIVE: We sought to identify whether there is an increased risk of specific congenital anomalies after exposure to antiasthma medication in the first trimester of pregnancy.
METHODS: We performed a population-based case-malformed control study testing signals identified in a literature review. Odds ratios (ORs) of exposure to the main groups of asthma medication were calculated for each of the 10 signal anomalies compared with registrations with nonchromosomal, nonsignal anomalies as control registrations. In addition, exploratory analyses were done for each nonsignal anomaly. The data set included 76,249 registrations of congenital anomalies from 13 EUROmediCAT registries.
RESULTS: Cleft palate (OR, 1.63; 95% CI, 1.05-2.52) and gastroschisis (OR, 1.89; 95% CI, 1.12-3.20) had significantly increased odds of exposure to first-trimester use of inhaled β2-agonists compared with nonchromosomal control registrations. Odds of exposure to salbutamol were similar. Nonsignificant ORs of exposure to inhaled β2-agonists were found for spina bifida, cleft lip, anal atresia, severe congenital heart defects in general, or tetralogy of Fallot. None of the 4 literature signals of exposure to inhaled steroids were confirmed (cleft palate, cleft lip, anal atresia, and hypospadias). Exploratory analyses found an association between renal dysplasia and exposure to the combination of long-acting β2-agonists and inhaled corticosteroids (OR, 3.95; 95% CI, 1.99-7.85).
CONCLUSIONS: The study confirmed increased odds of first-trimester exposure to inhaled β2-agonists for cleft palate and gastroschisis and found a potential new signal for renal dysplasia associated with combined long-acting β2-agonists and inhaled corticosteroids. Use of inhaled corticosteroids during the first trimester of pregnancy seems to be safe in relation to the risk for a range of specific major congenital anomalies.
Keywords
Adrenal Cortex Hormones/adverse effects, Adrenal Cortex Hormones/therapeutic use, Adrenergic beta-2 Receptor Agonists/adverse effects, Adrenergic beta-2 Receptor Agonists/therapeutic use, Anti-Asthmatic Agents/adverse effects, Anti-Asthmatic Agents/therapeutic use, Asthma/drug therapy, Case-Control Studies, Congenital Abnormalities/epidemiology, Congenital Abnormalities/etiology, Europe/epidemiology, Female, Humans, Odds Ratio, Pregnancy, Pregnancy Trimester, First, Prenatal Exposure Delayed Effects, Risk
Pubmed
Web of science
Open Access
Yes
Create date
26/01/2016 9:13
Last modification date
20/08/2019 15:08
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