A population-based case-control teratologic study of acetylsalicylic acid treatments during pregnancy

Diseases of respiratory system caused by acute infections are among the most common maternal diseases during pregnancy. The objective of the study was to estimate the association between congenital abnormalities and acute respiratory infections during the first trimester of pregnancy. The data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities including 22 843 cases with congenital abnormalities, 38 151 population controls without congenital abnormalities and 834 malformed controls with Down syndrome between 1980 and 1996 was evaluated. 2118 cases with congenital abnormalities (9.3%), 3455 population controls (9.1%) and 92 malformed controls with Down syndrome (11.0%) had mothers with acute respiratory infections. Of 25 different congenital abnormality groups, esophageal atresia/stenosis showed a high adjusted prevalence odds ratios (POR) with 95% confidence interval (CI) for acute respiratory infections during the first trimester of pregnancy in case mothers compared with population controls (3.6, 1.4-9.1) and malformed controls (1.9, 1.0-3.5), respectively. In addition there was an association between medically recorded acute respiratory infections during the first trimester of pregnancy and a higher risk for some other congenital abnormalities, such as posterior cleft palate and multiple congenital abnormalities. In conclusion a possible association between some congenital abnormalities, particularly esophageal atresia/stenosis and maternal acute respiratory infections cannot be excluded due to the interactions of the microbial agents, related drug treatments and last but not least the indirect effect of maternal diseases, such as fever-hyperthermia, hypoxia and dietary deficiency. However, periconceptional multivitamin/folic acid supplementation during the early pregnancy was able to reduce the acute respiratory infection related risk for congenital abnormalities.

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“…2001b), penamecillin (Czeizel et al . 1999), acetylsalicylic acid (Czeizel et al . 2000; Norgard et al .…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory infections during pregnancy and congenital abnormalities: a population‐based case‐control study

Ács

Bánhidy

Puhó

et al. 2006

Congenital Anomalies

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“…The benefits of the HCCSCA are (i) the population‐based, (ii) large dataset including 173 control newborn infants born to mothers with paracetamol treatment, (iii) in racially homogeneous (European‐Caucasian) people, (iv) who had medically recorded birthweight and gestational age. However, this dataset also has drawbacks: (i) Paracetamol was used rarely as an antifever drug during pregnancy in Hungary, because the previously introduced treatments (particularly acetylsalicylates) have remained more popular 7 . (ii) The response rate of women was 83%.…”

Section: Discussionmentioning

confidence: 99%

“…A similar finding was published in the CLASP trial where low‐dose aspirin reduced preterm delivery in pregnant women with pre‐eclampsia, 15 and acetylsalicylic acid can also have an effect due to the reduction of prostacyclin. Previously we evaluated the teratogenic potential of acetylsalicylic acid treatment during pregnancy, 7 but gestational age and birthweight were not included in the study. Now we have checked the dose‐dependent effect of acetylsalicylic acid after the use of 100 mg and 500 mg in the HCCSCA.…”

Section: Discussionmentioning

confidence: 99%

Short‐term paracetamol therapy during pregnancy and a lower rate of preterm birth

Czeizel

Dudás

Puhó

2005

Paediatric Perinatal Epid

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The relationships between short-term oral paracetamol treatment during pregnancy and mean gestational age and birthweight, in addition to the prevalence of preterm birth and low birthweight were estimated using newborn infants in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Gestational age and birthweight were medically recorded. Of 38 151 newborn infants, 173 were born to mothers who had paracetamol treatment during pregnancy. A 0.4-week increase in the mean gestational age was found among exposed relative to unexposed, and with the use of paracetamol during pregnancy there was a significant reduction in the proportion of preterm birth (3.5% vs. 9.2%) (adjusted P = 0.01). The possible preterm birth protective effect of paracetamol may be associated with paracetamol-induced reduction of prostacyclin production in pregnant women. The clinical relevance of these findings needs further studies.

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“…Maternal use of therapeutic drugs, such as analgesics and antipyretics (Czeizel et al, ; Feldkamp et al, ; Broussard et al, ; van Gelder et al, ), antimicrobials or antibiotics (Czeizel et al, ,b; Crider et al, ), antidepressants (Alwan et al, ; Källén and Otterblad, ; Reis and Källén, ), antihistamines (Gilboa et al, ), hypotensive medication (Bánhidy et al, ), barbiturates (Browne et al, 2014), and decongestants (Yau et al, ), did not seem to be associated with increased risks of ARM, although separate medical drugs were mostly evaluated in one study only. Maternal use of opioid analgesics during early pregnancy seemed to increase the risk, mainly for isolated ARM (Broussard et al, ).…”

Section: Nongenetic Factorsmentioning

confidence: 99%

Genetic and nongenetic etiology of nonsyndromic anorectal malformations: A systematic review

Wijers

Rooij

Marcelis

et al. 2014

Birth Defects Research Pt C

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Congenital anorectal malformations (ARMs) are one of the most frequently observed birth defects of the digestive system. However, their etiology remains elusive. Therefore, we aim to summarize and critically appraise all existing literature on the genetic and nongenetic etiology of nonsyndromic ARM and to conclude with unifying hypotheses and directions for future research. A structured literature search on English language human studies was conducted in PubMed and Embase up to October 1, 2013, resulting in 112 included articles. Research on the identification of genes underlying nonsyndromic ARM is remarkably scarce. Most studies were focused on screening of candidate genes for mutations or single-nucleotide polymorphisms, which did not yield any substantial evidence. Nongenetic factors fairly consistently found to be associated with ARM are assisted reproductive techniques, multiple pregnancy, preterm delivery, low birth weight, maternal overweight or obesity, and preexisting diabetes. This review provides indications for the involvement of both genes and nongenetic risk factors in the etiology of ARM. In future studies, large cohorts of patients with ARM from national and international collaborations are needed to acquire new hypotheses and knowledge through hypothesis-generating approaches. Challenges for future studies may also lie in the investigation of gene-gene and gene-environment interactions.

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A population-based case-control teratologic study of acetylsalicylic acid treatments during pregnancy

Cited by 20 publications

References 41 publications

Acute respiratory infections during pregnancy and congenital abnormalities: a population‐based case‐control study

Acute respiratory infections during pregnancy and congenital abnormalities: a population‐based case‐control study

Short‐term paracetamol therapy during pregnancy and a lower rate of preterm birth

Genetic and nongenetic etiology of nonsyndromic anorectal malformations: A systematic review

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