Key Findings

• ADHD Medication Use Among Pregnant Women
• Paternal Genetic Differences and Increased Risk of Conotruncal Heart Defects
• Maternal Stress and Social Support and Chance of Delivering Babies with Gastroschisis or Hypospadias
• Parental Occupational Pesticide Exposure and Nonsyndromic Orofacial Clefts
• Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects
• Maternal Antihypertensive Medication Use and Selected Birth Defects in the National Birth Defects Prevention Study
• Low Carbohydrate Diets May Increase Risk of Neural Tube Defects
• Secondhand Tobacco Smoke During Pregnancy and the Risk for Preterm or Small-for-Gestational Age Birth

 

ADHD Medication Use Among Pregnant Women

Key Findings

1. The number of women taking ADHD medicine during pregnancy more than doubled from 1998 to 2011. By 2010-2011, about 1 in 100 women took ADHD medicine during pregnancy.
2. Taking ADHD medicine in early pregnancy may be related to the birth defects such as, gastroschisis, omphalocele, and transverse limb deficiency.
3. Although our study found some increased risk for birth defects, it is important to remember that there’s a very low risk of having a baby born with these defects after taking ADHD medicine.
4. Women should talk with their healthcare providers about options for managing ADHD symptoms before and during pregnancy.

Anderson KN, Dutton AC, Broussard CS, Farr SL, Lind JN, Visser SN, Ailes EC, Shapira SK, Reefhuis J, Tinker SC. ADHD Medication Use During Pregnancy and Risk for Selected Birth Defects: National Birth Defects Prevention Study, 1998-2011. Journal of Attention Disorders. 2020 Feb;24(3):479-489. doi: 10.1177/1087054718759753.

More Information: https://www.cdc.gov/pregnancy/meds/treatingfortwo/features/keyfinding-ADHD-med-increase.html

 

Paternal Genetic Differences and Increased Risk of Conotruncal Heart Defects

Key Findings

1. Congenital heart defects  are the most common birth defect, affecting about 1 in every 110 births in the United States annually.
2. While the causes of most heart defects are unknown, both maternal and paternal factors may increase risk for heart defects.
3. While maternal genetic variants in metabolic gene pathways have been associated with heart defect risk, paternal genetic variants in the same metabolic pathways didn’t show a similar increased risk for conotruncal heart defects, a group of specific heart defects.
4. Three genetic variants were associated with a decreased risk of conotruncal defects in a child who inherited a paternally-derived copy of the gene compared to children who inherited a maternal copy.

Nembhard WN, Tang X, Li J, MacLeod SL, Levy J, Schaefer GB, & Hobbs CA. A parent-of-origin analysis of paternal genetic variants and increased risk of conotruncal heart defects. Am J Med Genet A. 2018 Mar;176(3):609-617. doi:10.1002/ajmg.a.38611.

 

Maternal Stress and Social Support and Chance of Delivering Babies with Gastroschisis or Hypospadias

Key Findings

1. Gastroschisis is a birth defect where a baby’s intestines are found outside of the baby’s body, exiting through a hole beside the belly button. Hypospadias is a genital defect in male babies where the urethra is not located on the tip of the penis.
2. Mothers, age 20 years and older, who had increased levels of social support around the start of their pregnancy were less likely to deliver a baby with gastroschisis or hypospadias.
3. Mothers, age 20 years and older, who reported an increased number of stressful life events that occurred before pregnancy or during the first trimester were more likely to deliver a baby with gastroschisis.
4. Despite increased levels of social support, the chance of delivering a baby with gastroschisis or hypospadias did not decrease among mothers who indicated high levels of stressful events.

Carmichael SL, Ma C, Tinker S, Shaw GM. Maternal Stressors and Social Support and Risks of Delivering Babies With Gastroschisis or Hypospadias. American Journal of Epidemiology. 2017 Jun;185(12):1240-1246. doi: 10.1093/aje/kww121.

 

Parental Occupational Pesticide Exposure and Nonsyndromic Orofacial Clefts

Key Findings

1. Orofacial clefts are birth defects that occur when the lip and/or palate do not develop normally during early pregnancy, resulting in cleft lip with/without cleft palate, or cleft palate alone.
2. Mothers exposed to pesticides didn’t appear to have an increased risk of delivering a child with an orofacial cleft
3. Paternal occupational exposure to a combination of fungicides, herbicides, and insecticides may increase the risk for cleft palate.

Suhl J, Romitti PA, Rocheleau CM, Cao Y, Burns TL, Conway K, Langlois P. Parental occupational pesticide exposure and nonsyndromic orofacial clefts. J Occup Enviorn Hyg. 2018 Sep;15(9):641-653. doi: 10.1080/15459624.2018.1484127.

 

Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects

Key Findings

1. The use of Ondansetron (Zofran) is increasing among pregnant women to treat nausea and vomiting.
2. Using Ondansetron during pregnancy didn’t increase the risk for most birth defects studied.
3. Cleft palate and renal agenesis, a type of kidney defect, may be more common among women using Ondansetron, although they occur very rarely.

Parker ES, Van Bennekom C, Anderka M, Mitchell AA. Ondansetron for Treatment of Nausea and Vomitting of Pregnancy and the Risk of Specific Birth Defects. Obstetrics & Gynecology.  2018 Aug;132(2):385-394. doi:10.1097/AOG.0000000000002679.

More Information: https://www.cdc.gov/ncbddd/birthdefects/features/kf-ondansetron-and-birth-defects.html

 

Maternal Antihypertensive Medication Use and Selected Birth Defects in the National Birth Defects Prevention Study

Key Findings

1. About 1 in 100 women in our study reported using medication for high blood pressure during the first trimester of their pregnancies.
2. Maternal antihypertensive medication use wasn’t strongly linked with most of the 28 non-cardiac birth defects we studied.
3. There was an increased risk for small intestinal atresia and anencephaly and use of antihypertensives early in pregnancy.
4. There was no evidence of an increased risk for birth defects associated with use of any particular class of antihypertensive medication, so we don’t know whether or not certain types of antihypertensive medications are safer than others.
   

Fisher SC, Van Zutphen AR, Werler MM, Romitti PA, Cunniff CM, Browne ML. Maternal Antihypertensive Medication Use and Selected Birth Defects in the National Birth Defects Prevention Study. Birth Defects Research. 2018 Nov 15;110(19):1433-1442. doi: 10.1002/bdr2.1372.

 

Low Carbohydrate Diets May Increase Risk of Neural Tube Defects

Key Findings

1. Folic acid is a synthetic or man-made version of a natural B-vitamin called folate, which is found in some foods including green leafy vegetables. Getting enough folate or folic acid before and during pregnancy is important because it can help prevent some birth defects of the brain and spine known as neural tube defects.
2. Most grain products in the United States are fortified or “boosted” with folic acid to help prevent neural tube defects. Fortified foods include things like bread, pasta, and cereal – foods which can also be high in carbohydrates.
3. Women who ate the lowest amounts of carbohydrates were more likely to have a baby with spina bifida (a birth defect of the spine) or anencephaly (a birth defect of the brain).
4. Women should talk with their health care provider before and during pregnancy about the pros and cons of any dietary restrictions or preferences.

Desrosiers TA, Siega-Riz AM, Mosley BS, Meyer RE. Low Carbohydrate Diets May Increase Risk of Neural Tube Defects. Birth Defects Res. 2018 Jul;110(11):901-909. doi:10.1002/bdr2.1198.

 

Secondhand Tobacco Smoke During Pregnancy and the Risk for Preterm or Small-for-Gestational Age Birth

Key Findings

1. Almost 14% of women in the study reported secondhand smoke exposure.
2. There was an increased risk of having a preterm birth among non-smoking pregnant women with secondhand smoke exposure.
3. Maternal exposure to secondhand smoke in the household and workplace or school was associated with preterm birth.
4. There was no evidence to support maternal secondhand smoke exposure during pregnancy is associated with small-for-gestational age births.
   

Hoyt AT, Canfield MA, Romitti PA, Botto LD, Anderka MT, Krikov SV, Feldkamp ML. Does Maternal Exposure to Secondhand Tobacco Smoke During Pregnancy Increase the Risk for Preterm or Small-for-Gestational Age Birth? Matern Child Health J. 2018 Oct;22(10):1418-1429. doi:10.1007/s10995-018-2522-1.