2017
DOI: 10.1016/j.annepidem.2017.09.003
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Risk comparison for prenatal use of analgesics and selected birth defects, National Birth Defects Prevention Study 1997–2011

Abstract: Purpose To compare the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and/or opioids to the use of acetaminophen without NSAIDs or opioids with respect to associations with birth defects. Methods We used data from the National Birth Defects Prevention Study (1997–2011). Exposure was self-reported maternal analgesic use from the month before through the third month of pregnancy (periconceptional). Adjusted odds ratios (aORs) were calculated to examine associations with 16 birth defects. Results Compar… Show more

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Cited by 66 publications
(50 citation statements)
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“…We observed higher odds of delivering an infant with gastroschisis with acetaminophen use in the beginning of pregnancy among women younger than 20 but after adjustment for other variables such as urinary tract infection the odds were attenuated. Associations between maternal use of various medications and gastroschisis have been studied previously (Ahrens et al, ; Alwan, Reefhuis, Rasmussen, Olney, & Friedman, ; Draper et al, ; Feldkamp, Meyer, Krikov, & Botto, ; Interrante et al, ; Lin et al, ; Polen, Rasmussen, Riehle‐Colarusso, & Reefhuis, ; Waller et al, ; Werler et al, ; Werler, Sheehan, & Mitchell, ). However, acetaminophen was the only important predictor we identified of the medications included in our analysis.…”
Section: Discussionmentioning
confidence: 94%
“…We observed higher odds of delivering an infant with gastroschisis with acetaminophen use in the beginning of pregnancy among women younger than 20 but after adjustment for other variables such as urinary tract infection the odds were attenuated. Associations between maternal use of various medications and gastroschisis have been studied previously (Ahrens et al, ; Alwan, Reefhuis, Rasmussen, Olney, & Friedman, ; Draper et al, ; Feldkamp, Meyer, Krikov, & Botto, ; Interrante et al, ; Lin et al, ; Polen, Rasmussen, Riehle‐Colarusso, & Reefhuis, ; Waller et al, ; Werler et al, ; Werler, Sheehan, & Mitchell, ). However, acetaminophen was the only important predictor we identified of the medications included in our analysis.…”
Section: Discussionmentioning
confidence: 94%
“…An estimated 50%-70% of women use analgesic and antipyretic drugs during pregnancy, with acetaminophen (eg paracetamol, Tylenol) the most commonly used during this period. [1][2][3] Although acetaminophen crosses the placenta, it has been assigned a "Pregnancy Category B" status by the US Food and Drug Administration and is considered safe for use during all stages of pregnancy. 1,4 However, in recent years, the use of acetaminophen in pregnancy has been associated with an increased risk of asthma and wheezing, 5 congenital malformations, 2 and neurodevelopmental disorders in the offspring.…”
Section: Backg Rou N Dmentioning
confidence: 99%
“…[1][2][3] Although acetaminophen crosses the placenta, it has been assigned a "Pregnancy Category B" status by the US Food and Drug Administration and is considered safe for use during all stages of pregnancy. 1,4 However, in recent years, the use of acetaminophen in pregnancy has been associated with an increased risk of asthma and wheezing, 5 congenital malformations, 2 and neurodevelopmental disorders in the offspring. [6][7][8] Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in childhood.…”
Section: Backg Rou N Dmentioning
confidence: 99%
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“…Both opioids and nonsteroidal anti-inflammatory drugs have been linked to birth defects. 20 While prevalence of opioid use in pregnancy has not been documented in the MHS, studies suggest that overprescription occurs in obstetric and gynecologic contexts, 10 and the 2017 National Defense Authorization Act specifically charged the MHS with greater oversight of opioids. 21 Acupuncture potentially is a safer alternative for pain control in pregnancy, but, at a maximum of 130 visits across a minimum of 41,154 births 9 per year, this therapy is provided to 0.3% or less women who receive obstetric care in the MHS.…”
Section: Acupuncture For Pregnancy In the Mhs 369mentioning
confidence: 99%