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Findings by Health Condition

Chronic health conditions—those that go on for a long time and often do not go away completely—are serious. Without treatment, they may be life-threatening. CDC and its partners conduct important research on the effects of medicines used to treat health conditions during pregnancy. Listed below are key findings from some of our studies and suggested reading, including medical recommendations.

Are you pregnant or thinking about getting pregnant?

Talk to a healthcare professional about any medicines you are taking or thinking about taking. This includes prescriptions, over-the-counter medicines, herbal and dietary supplements, and vitamins. Although no medicine is completely risk-free, a healthcare professional can help you pick a treatment plan that works for you. Do not start any new medicines or stop a current medicine without talking to a healthcare professional.


Attention-Deficit / Hyperactivity Disorder (ADHD)

 Key Findings:
  • A 2018 study found the percentage of privately-insured U.S. women aged 15-44 who filled a prescription for a medicine to treat ADHD increased nearly 350% between 2003 and 2015.
  • A 2018 study found that that women who took ADHD medicine during early pregnancy may be more likely to have a baby with some types of birth defects compared to women who did not take ADHD medicine.
Suggested Reading:

Attention-Deficit/Hyperactivity Disorder Medication Prescription Claims Among Privately Insured Women Aged 15–44 Years—United States, 2003–2015.
MMWR Morb Mortal Wkly Rep 2018; 67: 66–70.
Anderson KN, Ailes EC, Danielson M, Lind JN, Farr SL, Broussard CS, Tinker SC.
[Read article]

ADHD medication use during pregnancy and risk for selected birth defects: National Birth Defects Prevention Study, 1998-2011.
Journal of Attention Disorders. 2018.
Anderson KN, Dutton AC, Broussard CS, Farr SL, Lind JN, Visser SN, Ailes EC, Shapira SK, Reefhuis J, Tinker SC, and the National Birth Defects Prevention Study.
[Read summary]

Allergies

 Key Findings:
  • In a 2014 study, researchers reviewed more than 50 published scientific articles to see if there was a risk of birth defects from using allergy medicines, like antihistamines, during pregnancy. Researchers found the evidence to be generally reassuring: most antihistamines (e.g., loratadine) do not appear to be linked to birth defects. However, researchers need to study certain antihistamines, especially H2-receptor antagonists, further to determine if they increase the risk for birth defects.
Suggested Reading:

Antihistamines and birth defects: a systematic review of the literature
Expert Opin Drug Saf. 2014 Dec;13(12):1667-1698.
Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA.
[Read article]

The safety or risk of antihistamine use in pregnancy: Reassuring data are helpful but not sufficient
J Allergy Clin Immunol Pract.2013;1:675-676.
Honein MA and Moore CA.
[Read article]

Use of antihistamine medications during early pregnancy and isolated major malformations
Birth Defects Res A Clin Mol Teratol. 2009;85(2):137-150
Gilboa SM, Strickland MJ, Olshan AF, Werler MW, Correa A, and the National Birth Defects Prevention Study.
[Read article]

Maternal corticosteroid use and hypospadias
J Pediatr. 2009;155(1):39-44.
Carmichael SL, Ma C, Werler MM, Olney RS, Shaw GM, and the National Birth Defects Prevention Study.
[Read article]

Maternal corticosteroid use and orofacial clefts
Am J Obstet Gynecol. 2007 Dec;197(6):585.e1-7; discussion 683-4, e1-7.
Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, Lammer EJ, and the National Birth Defects Prevention Study.
[Read summary]

Arthritis and Lupus

Key Findings:
  • A 2014 study and other case reports found that pregnant women taking methotrexate, a medicine used to treat arthritis, have an increased risk of having a baby with birth defects, particularly congenital heart defects.
  • A 2009 case report suggests that pregnant women taking mycophenolate mofetil (MMF; CellCept), which is used to help prevent transplant organ rejection or to treat lupus nephritis, have an increased risk of having a baby with birth defects.
Suggested Reading:

Maternal exposure to methotrexate and birth defects: A population-based study
Am J Med Genet A. 2014;164(9):2212-2216.
Dawson AL, Riehle-Colarusso T, Reefhuis J, Arena JF, and the National Birth Defects Prevention Study.
[Read article]

Reviewing the evidence for mycophenolate mofetil as a new teratogen: case report and review of the literature
Am J Med Genet A. 2009;149A(6):1241-1248.
Anderka MT, Lin AE, Abuelo DN, Mitchell AA, Rasmussen SA.
[Read summary]

Maternal corticosteroid use and hypospadias
J Pediatr. 2009;155(1):39-44.
Carmichael SL, Ma C, Werler MM, Olney RS, Shaw GM, and the National Birth Defects Prevention Study.
[Read article]

Maternal corticosteroid use and orofacial clefts
Am J Obstet Gynecol. 2007 Dec;197(6):585.e1-7; discussion 683-4, e1-7.
Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, Lammer EJ, and the National Birth Defects Prevention Study.
[Read summary]

Asthma

Key Findings:
Suggested Reading:

Maternal asthma medication use and the risk of selected birth defects
Pediatrics. 2012;129(2):e317-324.
Lin S, Munsie JP, Herdt-Losavio ML, Druschel CM, Campbell K, Browne ML, Romitti PA, Olney RS, Bell EM, and the National Birth Defects Prevention Study.
[Read summary] [Read key findings]

Maternal bronchodilator use and the risk of orofacial clefts
Hum Reprod. 2011;26(11):3147-3154.
Munsie JW, Lin S, Browne ML, Campbell KA, Caton AR, Bell EM, Rasmussen SA, Romitti PA, Druschel CM, and the National Birth Defects Prevention Study.
[Read summary]

Maternal asthma, asthma medication use, and the risk of congenital heart defects
Birth Defects Res A Clin Mol Teratol. 2009;85(2):161-168.
Lin S, Herdt-Losavio M, Gensburg L, Marshall E, Druschel C, and the National Birth Defects Prevention Study.
[Read summary]

Maternal corticosteroid use and hypospadias
J Pediatr. 2009;155(1):39-44.
Carmichael SL, Ma C, Werler MM, Olney RS, Shaw GM, and the National Birth Defects Prevention Study.
[Read article]

Maternal asthma medication use and the risk of gastroschisis
Am J Epidemiol. 2008;168(1):73-79.
Lin S, Munsie JP, Herdt-Losavio ML, Bell EM, Druschel C, Romitti PA, Olney RS, and the National Birth Defects Prevention Study.
[Read article]

Maternal corticosteroid use and orofacial clefts
Am J Obstet Gynecol. 2007 Dec;197(6):585.e1-7; discussion 683-4, e1-7.
Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, Lammer EJ, and the National Birth Defects Prevention Study.
[Read summary]

Guidelines and Recommendations:

Asthma controller therapy during pregnancy
Am J Obstet Gynecol. 2005; 192(2):369-380.
Gluck JC, Gluck PA.
[Read summary]

Managing asthma during pregnancy: recommendations for pharmacologic treatment–Update 2004
These NIH recommendations, updated during 2004, provide guidance on medication treatment for pregnant women with asthma.
[Read recommendations]

Depression

Frequency of Use:
  • In a 2011 study of pregnancies between 1998 and 2005, about 1 in 20 women reported using an antidepressant (frequently used to treat depression or anxiety) 3 months before becoming pregnant or during the pregnancy.
    • Use of selective serotonin-reuptake inhibitors (SSRIs) was reported most often (about 1 in 25 women), followed by bupropion [Wellbutrin®] (about 1 in 100 women).
    • About 1 in 3 women using an antidepressant medicine in the first month of pregnancy stopped its use by the second month of pregnancy, which appears to be related to the time women often find out they are pregnant.
    • Data from 4 states showed that the frequency of reported antidepressant use during pregnancy increased from 1 in 40 women in 1998 to about 1 in 12 women in 2005.
  • A 2012 study of pregnant and non-pregnant women 18-44 years old (from 2005-2009) showed that half of pregnant and non-pregnant women with depression received treatment, with prescription medicine as the most common type of treatment.
Key Findings:
  • Abruptly stopping the use of antidepressants can have serious consequences, and some women need to take antidepressants to appropriately manage their health condition.
  • At the same time, several studies have shown an increased risk for congenital heart defects when selective serotonin-reuptake inhibitors (SSRIs) are taken during early pregnancy.
  • Findings in a 2015 study refute some earlier reported links but confirm other links observed between birth defects and some SSRIs.
  • A 2007 study using data from the National Birth Defects Prevention Study showed that taking SSRIs during pregnancy may increase the risk of anencephaly, craniosynostosis, or omphalocele.
  • A 2010 study found that taking bupropion [Wellbutrin®](used to treat depression/anxiety and to quit smoking) during pregnancy might increase the risk of having a baby with certain congenital heart defects.
  • A 2013 study looked at venlafaxine use during the first trimester (first 3 months) of pregnancy and the risk for birth defects. Researchers found that venlafaxine use during early pregnancy was not common, but that it was more common among mothers of babies born with certain birth defects , including anencephaly, some congenital heart defects, cleft palate, and gastroschisis. This is the first study to show these links, so more research is needed to understand and confirm them.
Suggested Reading:

Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports
BMJ. 2015;351:h3190.
Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA, and the National Birth Defects Prevention Study.
[Read article] [Read key findings]

The association between reported venlafaxine use in early pregnancy and birth defects, National Birth Defects Prevention Study, 1997-2007
Birth Defects Res A Clin Mol Teratol. 2013;97(1):28-35.
Polen KND, Rasmussen SA, Riehle-Colarusso T, Reefhuis J, and the National Birth Defects Prevention Study.
[Read article]

Patterns of antidepressant medication use among pregnant women in a United States population
J Clin Pharmacol. 2011;51(2):264-270.
Alwan S, Reefhuis J, Rasmussen SA, Friedman JM, and the National Birth Defects Prevention Study.
[Read summary]

Maternal use of bupropion and risk for congenital heart defects
Am J Obstet Gynecol.  2010; 203(1):52.e1-6.
Alwan S, Reefhuis J, Botto LD, Rasmussen SA, Correa A, Friedman JM, and the National Birth Defects Prevention Study
[Read summary]

Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects
N Engl J Med. 2007;356(26):2684-2692.
Alwan S, Reefhuis J, Rasmussen SA, Olney RS, Friedman JM, and the National Birth Defects Prevention Study
[Read article]

Selective serotonin-reuptake inhibitors (SSRIs) and persistent pulmonary hypertension of the newborn [letter]
N Engl J Med. 2006;354:2188-2190.
Reefhuis J, Rasmussen SA, Friedman JM.
[Read letter]

Guidelines and Recommendations:

Use of psychiatric medications during pregnancy and lactation
American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 92.
Obstet Gynecol. 2008;111:1001–20.
ACOG Committee on Practice Bulletins—Obstetrics.
[ACOG members can access the bulletin here]

Epilepsy

Key Findings:
  • In a 2012 study researchers found that use of topiramate, a medicine used to treat epilepsy, during the first trimester (first 3 months) of pregnancy was linked to an increased risk of cleft lip with or without cleft palatein infants.
  • In a 2011 study researchers found that use of valproic acid and carbamazepine, medicines used to treat epilepsy and sometimes other diseases, such as migraine headaches and bipolar disorder, during pregnancy was linked to an increased risk of cleft palate and spina bifida.
Suggested Reading:

Use of topiramate in pregnancy and risk of oral clefts
Am J Obstet Gynecol. 2012;207(5):405.e1-7
Margulis AV, Mitchell AA, Gilboa SM, Werler MM, Mittleman MA, Glynn RJ, and the National Birth Defects Prevention Study.
[Read article] [Read key findings]

Use of antiepileptic medications in pregnancy in relation to risks of birth defects
Ann Epidemiol. 2011;21(11):842-850.
Werler MM, Ahrens KA, Bosco JL, Mitchell AA, Anderka MT, Gilboa SM, Holmes LB, and the National Birth Defects Prevention Study.
[Read article]

Influencing clinical practice regarding the use of antiepileptic medications during pregnancy: modeling the potential impact on the prevalences of spina bifida and cleft palate in the United States
Am J Med Genet C Semin Med Genet. 2011;157(3):234-246
Gilboa SM, Broussard CS, Devine OJ, Duwe KN, Flak AL, Boulet SL, Moore CA, Werler MM, Honein MA.
[Read summary] [Read key findings]

Guidelines and Recommendations:

Practice Parameter update: Management issues for women with epilepsy—Focus on pregnancy (an evidence based review): Teratogenesis and perinatal outcomes.
Neurology. 2009;73:133-141.
Harden CL, Meador KJ, Pennell PB, et al.
[
Read recommendations]

High Blood Pressure (Hypertension)

Key Findings:
  • A 2009 study found that pregnant women who have high blood pressure (hypertension) or took certain hypertension medicines appeared to have an increased risk of having a baby with certain congenital heart defects.
Suggested Reading:

Maternal Antihypertensive Medication Use and Congenital Heart Defects: Updated Results From the National Birth Defects Prevention Study.
Hypertension. 2017; 69:1-14.
Fisher SC, Van Zutphen AR, Werler MM, Lin AE, Romitti PA, Druschel CM, Browne ML.
[Read article]

Maternal hypertension, medication use, and hypospadias in the National Birth Defects Prevention Study.
Obstet Gynecol. 2014;123(2):309-17.
Van Zutphen AR, Werler MM, Browne MM, Romitti PA, Bell EM, McNutt LA, Druschel CM, Mitchell AA.
[Read article]

Antihypertensive medication use during pregnancy and the risk of cardiovascular malformations
Hypertension. 2009;54(1):63-70.
Caton, AR, Bell EM, Druschel CM, Werler MM, Lin AE, Browne ML, McNutt LA, Romitti PA, Mitchell AA, Olney RS, Correa A, and the National Birth Defects Prevention Study.
[Read article]

Maternal exposure to statins and risk for birth defects: A case-series approach (research letter)
Am J Med Genet A. 2008;146A(20):2701-2705.
Petersen EE, Mitchell AA, Carey JC, Werler MM, Louik C, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read letter]

Maternal hypertension, antihypertensive medication use and the risk of severe hypospadias
Birth Defects Res A Clin Mol Teratol. 2008;82(1):34-40.
Caton AR, Bell EM, Druschel CM, Werler MM, Mitchell AA, Browne ML, McNutt LA, Romitti PA, Olney RS, Correa A, and the National Birth Defects Prevention Study.
[Read summary]

Infections (e.g., Colds, Urinary Tract Infections, Human Immunodeficiency Virus [HIV])

Frequency of Use:

In a 2009 study of U.S. pregnancies between 1997 and 2003, almost a third of women reported using antibiotics 3 months before becoming pregnant or while pregnant.

  • 2 in 100 women reported antibiotic use 3 months before becoming pregnant.
  • Antibiotic use increased during pregnancy, peaking at about 6 in 100 women during the fourth month.
  • Penicillins were the most frequently reported antibiotics, used by 6 in 100 pregnant women.
Key Findings:
  • In a 2009 study, taking penicillins, erythromycins, or cephalosporins (antibiotics used to treat infections), did not appear to increase the risk of birth defects. However, use of sulfonamide (often used in combination with trimethroprin, which is thought to increase the risk for birth defects) or nitrofurantoin was linked to several birth defects.
Suggested Reading:

Safety of influenza vaccination during pregnancy: A review of subsequent maternal obstetric events and findings from two recent cohort studies
Vaccine. 2014;32(26):3122-3127.
Naleway AL, Irving SA, Henninger ML, Li DK, Shifflett P, Ball S, Williams JL, Cragan J, Gee J, Thompson MG; for the Vaccine Safety Datalink and Pregnancy and Influenza Project.
[Read article]

Balancing competing risks: perinatal exposure to macrolides increases the risk of infantile hypertrophic pyloric stenosis
Evid Based Med. 2014; 19(6):239.
Honein MA, Cragan JD.
[Read article]

Antiherpetic medication use and the risk of gastroschisis: Findings from the National Birth Defects Prevention Study, 1997-2007.
Paediatr Perinat Epidemiol. 2013;27(4):340-5.
Ahrens KA, Anderka MT, Feldkamp ML, Canfield MA, Mitchell AA, Werler MM, and the National Birth Defects Prevention Study.
[Read article]

Antibacterial medication use during pregnancy and risk of birth defects, National Birth Defects Prevention Study
Arch Pediatr Adolesc Med. 2009;163(11):978-985.
Crider KS, Cleves MA, Reefhuis J, Berry RJ, Hobbs CA, Hu DJ, and the National Birth Defects Prevention Study.
[Read article]

Antifungal drugs and the risk of selected birth defects
Am J Obstet Gynecol. 2008;198(2):191.e1-7.
Carter TC, Druschel CM, Romitti PA, Olney R, Werler M, Mitchell A, and the National Birth Defects Prevention Study.
[Read summary]

Guidelines and Recommendations:

Preconception care for HIV-infected women
New York (NY): New York State Department of Health; 2010 Jul. 15.
[Read guidelines]

U.S. Public Health Service Task Force recommendations for use–of antiretroviral drugs in pregnant HIV-1–infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States
[Read recommendations]

ACOG Committee Opinion No. 494: Sulfonamides, nitrofurantoin, and risk of birth defects
Obstet Gynecol. 2011 Jun;117(6):1484-1485.
American College of Obstetricians and Gynecologists Committee on Obstetric Practice.
[Read recommendations]

Updated recommendations for antimicrobial prophylaxis among asymptomatic pregnant women after exposure to Bacillus anthracis
MMWR Morb Mortal Wkly Rep. 2001;50(43):960.
[Read recommendations]

Pregnant Women & Influenza (Flu)
[Read recommendations]

2010-2011 Influenza Antiviral Medications: Summary for Clinicians
[Read recommendations]

Vaccination Information for Women Who are Pregnant or Breastfeeding
[Read guidelines]

Infertility

Key Findings:
  • A 2010 study found that taking clomiphene citrate (commonly used to help women who have difficulty getting pregnant) just before or during early pregnancy might increase the risk of having a baby with certain birth defects. However, it is difficult to determine whether these findings are due to the use of the clomiphene citrate or because of some underlying health condition causing both the women’s infertility and the birth defect.
  • A 2005 study found that taking progestins (used to treat infertility and an ingredient found in birth control pills) during early pregnancy might increase the risk of having a baby with hypospadias.
Suggested Reading:

Use of clomiphene citrate and birth defects, National Birth Defects Prevention Study, 1997–2005
Hum Reprod. 2011;26(2):451-457.
Reefhuis J, Honein MA, Schieve LA, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read article]

Epidemiology of fertility treatment use among U.S. women with liveborn infants, 1997–2004
J Womens Health (Larchmt). 2010;19(3):407-416.
Duwe KN, Reefhuis J, Honein MA, Schieve LA, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read summary]

Assisted reproductive technology and major structural birth defects in the United States
Hum Reprod. 2008; 24(2):360-366.
Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read article]

Maternal progestin intake and risk of hypospadias
Arch Pediatr Adolesc Med. 2005;159(10):957-962.
Carmichael SL, Shaw GM, Laurent C, Croughan MS, Olney RS, Lammer EJ.
[Read article]

Pain

Frequency of Use:
  • A 2015 study found that during 2008–2012, on average, about 3 in 10 women aged 15-44 years with private health insurance and about 4 in 10 women with Medicaid filled a prescription for an opioid medicine.
Key Findings:
  • A 2017 review article found that use of opioids during pregnancy may be linked to various birth defects such as oral clefts, congenital heart defects, and clubfoot. However, many of the studies reviewed had issues with study methods and quality.
  • A 2013 study found that mothers who used opioids in the first two months of pregnancy were twice as likely to have a pregnancy affected by a severe birth defect of the brain and spine (anencephaly, encephalocele, or spina bifida) than mothers who didn’t use opioids during pregnancy.
  • A 2011 study found that some birth defects, including spina bifida and certain congenital heart defects, were linked with the use of opioids during early pregnancy.
  • A 2010 study found that taking acetaminophen (over-the-counter medicine used for pain relief) during the first trimester (first 3 months) of pregnancy does not appear to increase the risk of major birth defects. Also, taking acetaminophen might decrease the risk of some birth defects in the baby when a pregnant woman uses it to treat a fever. This is because untreated fever can increase the risk of some birth defects.
Suggested Reading:

Maternal use of opioids during pregnancy and congenital malformations: a systematic review
Pediatrics. 2017 May 19; e20164131.
Lind JN, Interrante JD, Ailes EC, Gilboa SM, Khan S, Frey MT, Dawson AL, Honein MA, Dowling NF, Razzaghi H, Creanga AA.
[Read article]

Opioid prescription claims among women of reproductive age – United States, 2008-2012
MMWR Morb Mortal Wkly Rep. 2015 Jan 23;64(2):37-41.
Ailes EC, Dawson AL, Lind JN, Gilboa SM, Frey MT, Broussard CS, Honein MA; Centers for Disease Control and Prevention (CDC).
[Read article]

Infant and maternal characteristics in neonatal abstinence syndrome –selected hospitals in Florida, 2010-2011
MMWR Morb Mortal Wkly Rep. 2015;64(8):213-216.
Lind JN, Petersen EE, Lederer PA, Phillips-Bell GS, Perrine CG, Li R, Hudak M, Correia J, Creanga A, Sappenfield W, Curran J.
[Read article]

Case-control analysis of maternal prenatal analgesic use and cardiovascular malformations: Baltimore-Washington Infant Study
Am J Obstet Gynecol. 2014;211(4):404.e1-e9.
Marsh CA, Cragan JD, Alverson CJ, Correa A.
[Read article]

Periconceptional use of opioids and the risk of neural tube defects
Obstet Gynecol. 2013;122(4):838-844.
Yazdy MM, Mitchell AA, Tinker SC, Parker SE, Werler MM.
[Read article]

Maternal drug use and its effect on neonates: a population-based study in Washington state
Obstet Gynecol. 2012;119(5):924-933.
Creanga AA, Sabel JC, Ko JY, Wasserman CR, Shapiro-Mendoza CK, Taylor P, Barfield W, Cawthon L, Paulozzi LJ.
[Read summary]

Nonsteroidal antiinflammatory drug use among women and the risk of birth defects
Am J Obstet Gynecol. 2012;206(3):228 e221-228.
Hernandez RK, Werler MM, Romitti P, Sun L, Anderka M, National Birth Defects Prevention Study.
[Read summary]

Maternal treatment with opioid analgesics and risk for birth defects
Am J Obstet Gynecol. 2011;204(4):314.e1-11.
Broussard CS, Rasmussen SA, Reefhuis J, Friedman JM, Jann MW, Riehle-Colarusso T, Honein MA, and the National Birth Defects Prevention Study.
[Read summary] [Read key findings]

Acetaminophen use in pregnancy and risk for birth defects: findings from the National Birth Defects Prevention Study
Obstet Gynecol. 2010;115(1):109-115.
Feldkamp ML, Meyer RE, Krikov S, Botto LD.
[Read summary]

Maternal use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), and muscular ventricular septal defects
Birth Defects Res A Clin Mol Teratol. 2004;70(3):107-113.
Cleves MA, Savell Jr VH., Raj S, Zhao W, Correa A, Werler MM, Hobbs CA.
[Read summary]

Guidelines and Recommendations:

ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy
Obstet Gynecol. 2012;119:1070-1076.
[Read summary]

Pregnancy Prevention (Birth Control)

Key Findings:
  • A 2005 study found that taking progestins (an ingredient found in birth control pills) during early pregnancy might increase the risk of having a baby with hypospadias.
Suggested Reading:

Use of oral contraceptives in pregnancy and major structural birth defects in offspring
Epidemiology. 2010;21(2):232-239.
Waller DK, Lockwood GT, Gallaway MS, Canfield MA, Scheuerle A, Hernandez-Diaz S, Louik C, Correa A, and the National Birth Defects Prevention Study.
[Read summary]

The association between use of spermicides or male condoms and major structural birth defects
Contraception. 2009;80(5):422-429.
Gallaway MS, Waller DK, Canfield MA, Scheuerle A, and the National Birth Defects Prevention Study.
[Read summary]

Maternal progestin intake and risk of hypospadias
Arch Pediatr Adolesc Med. 2005;159(10):957-962.
Carmichael SL, Shaw GM, Laurent C, Croughan MS, Olney RS, Lammer EJ.
[Read article]

Thyroid Disorders

Key Findings:
Suggested Reading:

Thyroid Medication Use and Birth Defects in the National Birth Defects Prevention Study.
Birth Defects Res. 2017;109(18):1471-81.
Howley MM, Fisher SC, Van Zutphen AR, Waller DK, Carmichael SL, Browne ML, National Birth Defects Prevention Study.
[Read article]

Maternal thyroid disease, thyroid medication use and selected birth defects in the National Birth Defects Prevention Study
Birth Defects Res A Clin Mol Teratol. 2009;85(7):621-628.
Browne ML, Rasmussen SA, Hoyt AT, Waller DK, Druschel CM, Caton AR, Canfield MA, Lin AE, Carmichael SL, Romitti PA, and the National Birth Defects Prevention Study.
[Read summary]

Maternal thyroid disease as a risk factor for craniosynostosis
Obstet Gynecol. 2007 Aug;110(2 Pt 1):369-77.
Rasmussen SA, Yazdy MM, Carmichael SL, Jamieson DJ, Canfield MA, Honein MA.
[Read summary]

Use of Supplements and Weight Loss Products

Frequency of Use:

In a 2010 study of pregnancies between 1998 and 2004, 1 in 10 women reported using an herbal product (not including prenatal vitamins) 3 months before becoming pregnant or during pregnancy.

  • During pregnancy, slightly less than 1 in 10 women used an herbal product and use was highest in the first trimester (first 3 months of pregnancy).
  • Women were more likely to use an herbal product with they were older than 30 years or had more than a high school education.
  • Ginger and ephedra were the most commonly reported herbal products used early in pregnancy; use of teas and chamomile were commonly reported throughout pregnancy.
Key Findings:
  • Findings from a 2013 study were reassuring that hypospadias is not related to use of the most common medicines and herbal supplements taken during early pregnancy.
  • A 2008 study suggested a link between use of weight loss products before conception or during early pregnancy and certain birth defects, but the possible mechanism for how this might occur is not clear.
Suggested Reading:

Maternal medication and herbal use and risk for hypospadias: data from the National Birth Defects Prevention Study, 1997-2007
Pharmacoepidemiol Drug Saf. 2013;22(7):783-793.
Lind JN, Tinker SC, Broussard CS, Reefhuis J, Carmichael SL, Honein MA, Olney RS, Parker SE, Werler MM, and the National Birth Defects Prevention Study.
[Read article]

Herbal use before and during pregnancy
Am J Obstet Gynecol. 2010;202(5):443.e1-6.
Broussard CS, Louik CA, Honein MA, Mitchell AA, and the National Birth Defects Prevention Study.
[Read summary]

Periconceptional use of weight loss products including ephedra and the association with birth defects
Birth Defects Res A Clin Mol Teratol. 2008;82(8):553-562.
Bitsko R, Reefhuis J, Louik C, Werler MM, Feldkamp ML, Waller K, Frias J, Honein MA, and the National Birth Defects Prevention Study.
[Read summary]

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