TY - JOUR
T1 - Maternal antihypertensive medication use and selected birth defects in the National Birth Defects Prevention Study
AU - the National Birth Defects Prevention Study
AU - Fisher, Sarah C.
AU - Van Zutphen, Alissa R.
AU - Werler, Martha M.
AU - Romitti, Paul A.
AU - Cunniff, Christopher
AU - Browne, Marilyn L.
N1 - Funding Information:
We thank the participating families, scientists, and staff from all of the NBDPS sites. Drug information in the NBDPS is coded using the Slone Epidemiology Center Drug Dictionary, under license from the Slone Epidemiology Center at Boston University. This study was supported by a cooperative agreement from the Centers for Disease Control and Prevention (Cooperative Agreement U01DD001032). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This study was presented, in part, as a poster at the 28th Annual Meeting of the Society for Pediatric and Perinatal Epidemiologic Research (SPER) in Denver, Colorado, USA, June 15–16, 2015. We thank Cristian Pantea for replicating the analyses.
Funding Information:
We thank the participating families, scientists, and staff from all of the NBDPS sites. Drug information in the NBDPS is coded using the Slone Epidemiology Center Drug Dictionary, under license from the Slone Epidemiology Center at Boston University. This study was supported by a cooperative agreement from the Centers for Disease Control and Prevention (Cooperative Agreement U01DD001032). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This study was presented, in part, as a poster at the 28th Annual Meeting of the Society for Pediatric and Perinatal Epidemiologic Research (SPER) in Denver, Colorado, USA, June 15?16, 2015. We thank Cristian Pantea for replicating the analyses.
Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/11/15
Y1 - 2018/11/15
N2 - Background: There are limited data on the relationship between antihypertensive medication use in early pregnancy and risk of birth defects. Methods: Using data from the National Birth Defects Prevention Study, we examined associations between specific antihypertensive medication classes and 28 noncardiac birth defects. We analyzed self-reported data on 17,038 case and 11,477 control pregnancies with estimated delivery dates during 1997–2011. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals, adjusted for maternal age, race/ethnicity, body mass index, parity, pregestational diabetes, and study site, for associations between individual birth defects and antihypertensive medication use during the first trimester of pregnancy. We compared risk among women reporting early pregnancy antihypertensive medication use to normotensive women. Results: Hypertensive women who reported early pregnancy antihypertensive medication use were more likely to be at least 35 years old, non-Hispanic Black, obese, multiparous, and to report pregestational diabetes than normotensive women. Compared to normotensive women, early pregnancy antihypertensive medication use was associated with increased risk of small intestinal atresia (adjusted OR 2.4, 95% CI 1.2–4.7) and anencephaly (adjusted OR 1.9, 95% CI 1.0–3.5). Risk of these defects was not specific to any particular medication class. Conclusions: Maternal antihypertensive medication use was not associated with the majority of birth defects we analyzed, but was associated with an increased risk for some birth defects. Because we cannot entirely rule out confounding by the underlying hypertension and most ORs were based on small numbers, the increased risks observed should be interpreted with caution.
AB - Background: There are limited data on the relationship between antihypertensive medication use in early pregnancy and risk of birth defects. Methods: Using data from the National Birth Defects Prevention Study, we examined associations between specific antihypertensive medication classes and 28 noncardiac birth defects. We analyzed self-reported data on 17,038 case and 11,477 control pregnancies with estimated delivery dates during 1997–2011. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals, adjusted for maternal age, race/ethnicity, body mass index, parity, pregestational diabetes, and study site, for associations between individual birth defects and antihypertensive medication use during the first trimester of pregnancy. We compared risk among women reporting early pregnancy antihypertensive medication use to normotensive women. Results: Hypertensive women who reported early pregnancy antihypertensive medication use were more likely to be at least 35 years old, non-Hispanic Black, obese, multiparous, and to report pregestational diabetes than normotensive women. Compared to normotensive women, early pregnancy antihypertensive medication use was associated with increased risk of small intestinal atresia (adjusted OR 2.4, 95% CI 1.2–4.7) and anencephaly (adjusted OR 1.9, 95% CI 1.0–3.5). Risk of these defects was not specific to any particular medication class. Conclusions: Maternal antihypertensive medication use was not associated with the majority of birth defects we analyzed, but was associated with an increased risk for some birth defects. Because we cannot entirely rule out confounding by the underlying hypertension and most ORs were based on small numbers, the increased risks observed should be interpreted with caution.
KW - National Birth Defects Prevention Study
KW - antihypertensive
KW - birth defects
KW - hypertension
KW - pregnancy
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U2 - 10.1002/bdr2.1372
DO - 10.1002/bdr2.1372
M3 - Article
C2 - 30260586
AN - SCOPUS:85053048016
VL - 110
SP - 1433
EP - 1442
JO - Birth Defects Research
JF - Birth Defects Research
SN - 2472-1727
IS - 19
ER -