Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy: a cohort linkage study

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Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy : a cohort linkage study. / Garne, E.; Hansen, A. Vinkel; Morris, J.; Jordan, S.; Klungsoyr, K.; Engeland, A.; Tucker, D.; Thayer, D. S.; Davies, G. I.; Andersen, A-M Nybo; Dolk, H.

In: B J O G, Vol. 123, No. 10, 09.2016, p. 1609-1618.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Garne, E, Hansen, AV, Morris, J, Jordan, S, Klungsoyr, K, Engeland, A, Tucker, D, Thayer, DS, Davies, GI, Andersen, A-MN & Dolk, H 2016, 'Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy: a cohort linkage study', B J O G, vol. 123, no. 10, pp. 1609-1618. https://doi.org/10.1111/1471-0528.14026

APA

Garne, E., Hansen, A. V., Morris, J., Jordan, S., Klungsoyr, K., Engeland, A., ... Dolk, H. (2016). Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy: a cohort linkage study. B J O G, 123(10), 1609-1618. https://doi.org/10.1111/1471-0528.14026

Vancouver

Garne E, Hansen AV, Morris J, Jordan S, Klungsoyr K, Engeland A et al. Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy: a cohort linkage study. B J O G. 2016 Sep;123(10):1609-1618. https://doi.org/10.1111/1471-0528.14026

Author

Garne, E. ; Hansen, A. Vinkel ; Morris, J. ; Jordan, S. ; Klungsoyr, K. ; Engeland, A. ; Tucker, D. ; Thayer, D. S. ; Davies, G. I. ; Andersen, A-M Nybo ; Dolk, H. / Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy : a cohort linkage study. In: B J O G. 2016 ; Vol. 123, No. 10. pp. 1609-1618.

Bibtex

@article{7dba077682ea4e93964c091bc868f9f5,
title = "Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy: a cohort linkage study",
abstract = "Objective: To examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.Design: Meta-analysis of aggregated data from three cohort studies.Setting: Linkage between healthcare databases and EUROCAT congenital anomaly registries.Population: 519 242 pregnancies in Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010).Methods: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.Main outcome measures: ORs for all congenital anomalies and specific congenital anomalies.Results: Overall exposure prevalence was 3.76{\%}. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99{\%} CI 1.09–1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99{\%} CI 1.15–10.04). For severe congenital heart defects, an increased OR (1.97; 1.12–3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20–4.67).Conclusion: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken.",
keywords = "Asthma medication, congenital anomalies, first trimester exposure, inhaled beta-2 agonists, inhaled corticosteroids",
author = "E. Garne and Hansen, {A. Vinkel} and J. Morris and S. Jordan and K. Klungsoyr and A. Engeland and D. Tucker and Thayer, {D. S.} and Davies, {G. I.} and Andersen, {A-M Nybo} and H. Dolk",
year = "2016",
month = "9",
doi = "10.1111/1471-0528.14026",
language = "English",
volume = "123",
pages = "1609--1618",
journal = "B J O G",
issn = "1470-0328",
publisher = "Wiley-Blackwell",
number = "10",

}

RIS

TY - JOUR

T1 - Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy

T2 - a cohort linkage study

AU - Garne, E.

AU - Hansen, A. Vinkel

AU - Morris, J.

AU - Jordan, S.

AU - Klungsoyr, K.

AU - Engeland, A.

AU - Tucker, D.

AU - Thayer, D. S.

AU - Davies, G. I.

AU - Andersen, A-M Nybo

AU - Dolk, H.

PY - 2016/9

Y1 - 2016/9

N2 - Objective: To examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.Design: Meta-analysis of aggregated data from three cohort studies.Setting: Linkage between healthcare databases and EUROCAT congenital anomaly registries.Population: 519 242 pregnancies in Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010).Methods: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.Main outcome measures: ORs for all congenital anomalies and specific congenital anomalies.Results: Overall exposure prevalence was 3.76%. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99% CI 1.09–1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99% CI 1.15–10.04). For severe congenital heart defects, an increased OR (1.97; 1.12–3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20–4.67).Conclusion: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken.

AB - Objective: To examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.Design: Meta-analysis of aggregated data from three cohort studies.Setting: Linkage between healthcare databases and EUROCAT congenital anomaly registries.Population: 519 242 pregnancies in Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010).Methods: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.Main outcome measures: ORs for all congenital anomalies and specific congenital anomalies.Results: Overall exposure prevalence was 3.76%. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99% CI 1.09–1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99% CI 1.15–10.04). For severe congenital heart defects, an increased OR (1.97; 1.12–3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20–4.67).Conclusion: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken.

KW - Asthma medication

KW - congenital anomalies

KW - first trimester exposure

KW - inhaled beta-2 agonists

KW - inhaled corticosteroids

U2 - 10.1111/1471-0528.14026

DO - 10.1111/1471-0528.14026

M3 - Journal article

VL - 123

SP - 1609

EP - 1618

JO - B J O G

JF - B J O G

SN - 1470-0328

IS - 10

ER -

ID: 168926812