Fluconazole use during the first trimester of pregnancy was not associated with most major birth defects

2014 ◽  
Vol 160 (2) ◽  
pp. JC12
Author(s):  
Laura A. Magee
2016 ◽  
Author(s):  
Michael A Johansson ◽  
Luis Mier-y-Teran-Romero ◽  
Jennita Reefhuis ◽  
Suzanne M Gilboa ◽  
Susan L Hills

Zika virus (ZIKV) infection during pregnancy has been linked to birth defects,1 yet the magnitude of risk remains uncertain. A study of the Zika outbreak in French Polynesia estimated that the risk of microcephaly due to ZIKV infection in the first trimester of pregnancy was 0.95% (95% confidence interval: 0.34-1.91%), based on eight microcephaly cases identified retrospectively in a population of approximately 270,000 people with an estimated 66% ZIKV infection rate.2


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Ai Yoshihara ◽  
Jaeduk Yoshimura Noh ◽  
Natsuko Watanabe ◽  
Miho Fukushita ◽  
Masako Matsumoto ◽  
...  

Abstract Context Medical treatment of Graves disease during the first trimester has been the subject of controversy ever since treatment with an antithyroid drug during the first trimester was reported to possibly be associated with an increased risk of birth defects in newborns. Objective We investigated whether the incidence of birth defects among newborns born to mothers with Graves disease (GD) treated with propylthiouracil (PTU) during the first trimester of pregnancy was higher than in a control group that was not exposed to any medication. Methods We reviewed the cases of 1913 women with GD who gave birth between January 1, 2015, and May 31, 2019. Detailed information concerning the outcome of pregnancy and the presence of birth defects was collected at the first visit after the delivery and again 1 year after delivery. We classified the mothers and infants into 3 groups according to the treatment the mother had received for GD in the first trimester of pregnancy: a group in which the mothers had been treated with PTU alone (PTU group), a group in which the mothers had not been treated with any medication (control group), and a group in which the mothers had received some other medical treatment, such as thiamazole, potassium iodide, or 2 or more drugs (other treatment group). Results The incidence of malformed infant births was 5.5% (30/541 infants) in the PTU group and 5.7% (27/ 475 infants) in the control group. There were no specific birth defects in the PTU group, and there were no significant differences between PTU dosages or maternal thyroid function according to whether mothers had delivered a child with a birth defect. Conclusion The results of our retrospective study showed that treatment with PTU during the first trimester of pregnancy did not increase the incidence of birth defects among newborns.


PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 559-563
Author(s):  
Jun Zhang ◽  
Wen-wei Cai

Objective. To examine the association between the common cold with or without fever in the first 3 months of pregnancy and birth defects in offspring. Design. A case-control study. Setting. Data are from the Shanghai Birth Defects Monitoring Program, conducted in 29 hospitals in Shanghai, China from October 1, 1986 to September 30, 1987. Subjects. A total of 986 birth defects cases, 990 frequency-matched live birth controls, and 159 stillbirth controls. Results. Modestly elevated risk of birth defects was identified among women who reported having a cold with or without fever in the first trimester of pregnancy. Notably increased relative risks were observed for anencephalus (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 2.0 to 7.7), spina bifida (OR = 4.1, 95% CI = 1.7 to 9.7), hydrocephalus (OR = 2.3, 95 % CI = 1.1 to 5.1), cleft lip (OR = 2.2, 95 % CI = 1.4 to 3.4), and undescended testicle (OR = 1.8, 95 % CI = 1.0 to 3.0). Our study further found that the overall relative risks were consistent by using two different control groups, suggesting that this association was unlikely to be due to recall or report bias. Conclusion. Common cold in the first trimester of pregnancy may be associated with an increased risk of birth defects in offspring. However, these findings should be interpreted cautiously.


2020 ◽  
Author(s):  
Daniel R. Morales ◽  
Lionel Fonkwen ◽  
Hedvig M. Nordeng

ABSTRACTBackgroundMaternal anti-thyroid drug (ATD) use during the first trimester of pregnancy has been associated with an increased risk of birth defects in offspring. Uncertainty remains on the size of this risk and how it compares to untreated hyperthyroidism due to methodological limitations of previous studies.MethodsSystematic review of MEDLINE and EMBASE identifying observational studies examining ATD use during the first trimester of pregnancy and risk of birth defects. Data were extracted on study characteristics, adjusted effect estimates and comparator groups. Effect estimates were pooled using a random-effects generic inverse variance method of analysis and absolute risk calculated.ResultsSeven cohort studies and one case–control study (involving 6212322 pregnancies and 388976 birth defects) were identified. Compared to unexposed women without hyperthyroidism, the association between ATD first trimester use and birth defects in offspring was: adjusted risk ratio [aRR] 1.16 95% CI 1.08-1.25 for propylthyoruacil (PTU); aRR 1.28 95% CI 1.06-1.54 for methimazole/carbimazole (MMI/CMZ); aRR 1.51, 95% CI 1.16-1.97 for both MMI/CMZ and PTU; and aRR 1.15 95%CI 1.02-1.29 for untreated hyperthyroidism. The risk of major birth defects per 1000 live births was: 9.6 for PTU; 16.8 for MMI/CMZ; 30.6 for both MMI/CMZ and PTU; and 9.0 for untreated hyperthyroidism.ConclusionsWhen appropriately analysed this risk of birth defects associated with ATD use in the first trimester of pregnancy is attenuated. Although still elevated, the risk of birth defects is smallest with PTU compared to use of MMI/CMZ and may be similar to that of untreated hyperthyroidism.


Sign in / Sign up

Export Citation Format

Share Document