| Recent Findings
NBDPS researchers have over 200 project ideas and new topics are being added often. In 2009, 29 papers were published in medical and health journals. The results of some of these papers are discussed below.
Medication Use During Pregnancy
Using medicine during pregnancy is common. So, it is important to learn how this might affect a mother and her baby. More knowledge will help women and their doctors make better choices about treatments during pregnancy.
Using data from the NBDPS, researchers have been able to look at medication use over time. They have used these data to see what kinds of medications women were taking during pregnancy. They found that medication use during pregnancy has gone up over the last 30 years. During the first trimester of pregnancy, 70%–80% of women said they took at least one medicine. Most recently, about 50% of women said they took at least one prescription medicine during that time. This shows the need for continued research on the risks or safety of using these medicines during pregnancy.
Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S and the National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976–2008. Am J Obstet Gynecol. 2011 Jul;205(1):51.e1-8.
Medicine To Ease Morning Sickness and Risk of Birth Defects
Morning sickness, including nausea and vomiting, is common during pregnancy. Certain medicines can be used to treat morning sickness. We wanted to better understand how these medicines might affect a mother and her baby.
Nearly 70% of women in the study reported morning sickness during the first trimester. Of these women, about 15% took a medicine to ease their symptoms. The NBDPS researchers found that most of the medicines did not increase the risk for many of the birth defects that were studied. But for some birth defects, including hypospadias and cleft palate, there might have been some association. More studies are needed to further explore any possible links.
Anderka M, Mitchell AA, Louik C, Werler MM, Hernandez-Diaz S, Rasmussen SA, and the National Birth Defects Prevention Study. Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects. Birth Defects Res A Clin Mol Teratol. 2012 Jan;94(1):22-30.
Treatment With Prescription Painkillers (Opioids) and Birth Defects
Doctors often treat severe pain with prescription painkillers called opioids. Small amounts also can be found in some over-the-counter cough medicines. Unfortunately, we do not have definitive and comprehensive answers about the effects of prescription painkillers on a pregnant woman and her unborn baby. We were able to look at this issue using NBDPS data.
Treatment with these types of painkillers just before or during early pregnancy was reported by 2% to 3% of the women in the NBDPS. Codeine and hydrocodone (sold as Vicodin) were the most commonly used. Some birth defects, including spina bifida (a birth defect of the baby’s spine) and certain heart defects, were linked with use of a prescription painkiller use in our study. Previous studies found a similar link between codeine and heart defects. Our study was the first to find painkiller use related to other birth defects. When making treatment choices, women and their doctors should think about the benefits and risks of prescription painkillers.
Broussard CS, Rasmussen SA, Reefhuis J, Friedman JM, Jann MW, Riehle-Colarusso T, et al. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol. 2011 Apr;204(4):314.e1-11.
Clomiphene Citrate and Birth Defects
Clomiphene citrate, sold as Clomid or Serophene®, is a drug used to help women who have trouble getting pregnant. It is one of the most common medicines used for infertility. As such, it is important to understand any possible risks connected with using it.
NBDPS researchers found that using this medicine was more common among mothers of babies born with certain birth defects. These include craniosynostosis (a birth defect of the baby’s skull), some heart defects, and other birth defects. Some of the links with specific birth defects were observed for the first time. That is why more research is needed to learn if the risks came from using clomiphene citrate or from the reason the couple had trouble getting pregnant.
Reefhuis J, Honein MA, Schieve LA, Rasmussen SA and the National Birth Defects Prevention Study. Use of clomiphene citrate and birth defects, National Birth Defects Prevention Study, 1997-2005. Hum Reprod. 2011 Feb;26(2):451-7.
Birth Defects and Acetaminophen Use
Acetaminophen, sold as Tylenol®, is an over-the-counter medicine used to treat mild pain or to lower a fever. Often, it is found in cold or flu medications and prescription painkillers. Pregnant women often use it.
This study looked at acetaminophen use during early pregnancy (first 3 months). About 47% of mothers of babies with a birth defect and about 45% of mothers of babies without a birth defect said that they used it during the first trimester. Researchers did not find a link between acetaminophen use and any specific type of birth defect. However, they did find that acetaminophen used to lower a fever during pregnancy might have lowered the risk for certain birth defects.
Feldkamp ML, Meyer RE, Krikov S, Botto LD and the National Birth Defects Prevention Study. Acetaminophen use in pregnancy and risk of birth defects: findings from the National Birth Defects Prevention Study. Obstet Gynecol. 2010 Jan;115(1):109–15.
Smoking and Neural Tube Defects
Smoking cigarettes during pregnancy can lead to harmful effects for the baby. These include being born too small or too early. We looked at the effect of smoking on birth defects of the baby’s brain (anencephaly) and spinal cord (spina bifida). We also looked at the effects of secondhand smoke during pregnancy.
When compared to nonsmokers, pregnant women who were around secondhand smoke were more likely to have a baby with a spina bifida or anencephaly.
Suarez L, Ramadhani T, Felkner M, Canfield MA, Brender JD, Romitti PA, et al. Maternal smoking, passive tobacco smoke, and neural tube defects. Birth Defects Res A Clin Mol Teratol. 2011 Jan;91(1):29-33.
Genital Tract Infections and Birth Defects
Genital tract infections are common during pregnancy. Some studies have shown these infections during pregnancy can lead to adverse outcomes, including babies’ being born too early. We used NBDPS data to find out if these kinds of infections were linked to birth defects.
We found that genital tract infections were associated with an increased risk for some birth defects, including cleft lip and cleft palate. Some of these increased risks had not been seen before. Therefore, more studies are needed to confirm these findings.
Carter TC, Olney RS, Mitchell AA, Romitti PA, Bell EM, Druschel CM, and the National Birth Defects Prevention Study. Maternal self-reported genital tract infections during pregnancy and the risk of selected birth defects. Birth Defects Res A Clin Mol Teratol. 2011 Feb;91(2):108-16.
Caffeine and Selected Birth Defects
Caffeine is found in different food and drinks, including coffee, tea, chocolate, and soft drinks. Many women consume caffeine during pregnancy (about two of every three women). Often, we are asked about caffeine use and birth outcomes. To address this issue, we used NBDPS data to find out if using caffeine during pregnancy increased the chances for birth defects. Overall, the findings were reassuring and did not show an increase in risk for the birth defects we studied.
Browne ML, Hoyt AT, Feldkamp ML, Rasmussen SA, Marshall EG, Druschel CM, et al. Maternal caffeine intake and risk of selected birth defects in the National Birth Defects Prevention Study. Birth Defects Res A Clin Mol Teratol. 2011 Feb;91(2):93-101.
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