Maternal Periconceptional Illicit Drug Use and the Risk of Congenital Malformations

BACKGROUND:In 2004, the Survey on Drug Use and Health showed that 5% of American women reported use of an illicit drug during pregnancy. The results of studies determining the association between periconceptional illicit drug use and birth defects have been inconsistent. METHODS:We analyzed data fro...

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Bibliographic Details
Published in:Epidemiology (Cambridge, Mass.) Mass.), 2009-01, Vol.20 (1), p.60-66
Main Authors: van Gelder, Marleen M. H. J, Reefhuis, Jennita, Caton, Alissa R, Werler, Martha M, Druschel, Charlotte M, Roeleveld, Nel
Format: Article
Language:English
Subjects:
Abnormalities, Drug-Induced - epidemiology
Abnormalities, Drug-Induced - etiology
Addictive behaviors
Adult
Adult and adolescent clinical studies
Biological and medical sciences
Cannabis
Databases as Topic
Drug addiction
Epidemiology
Female
General aspects
Health Surveys
Humans
Infant, Newborn
Interviews as Topic
Medical sciences
Miscellaneous
Mothers
Pregnancy - drug effects
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Assessment
Substance-Related Disorders - complications
United States - epidemiology
Young Adult
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Summary:BACKGROUND:In 2004, the Survey on Drug Use and Health showed that 5% of American women reported use of an illicit drug during pregnancy. The results of studies determining the association between periconceptional illicit drug use and birth defects have been inconsistent. METHODS:We analyzed data from the National Birth Defects Prevention Study, a case-control study of major birth defects, and assessed all birth defects categories in which there were at least 250 interviewed case mothers. We included 10,241 infants with major congenital malformations (case infants) and 4,967 infants without major congenital malformations (control infants) born between 1997 and 2003 for whom there was a completed maternal interview with detailed information on prenatal illicit drug use and potential confounders. We used multivariable logistic regression to estimate the associations between cannabis, cocaine, and stimulant use in the month before pregnancy or during the first trimester (periconceptional period) and the occurrence of selected birth defects. RESULTS:In the periconceptional period, 5% of the 15,208 mothers reported any use of illicit drugs. We did not find associations between illicit drug use and most of the 20 eligible categories of congenital malformations. Periconceptional cannabis use seemed to be associated with an increased risk of anencephaly (adjusted odds ratio = 1.7; 95% confidence interval = 0.9–3.4), whereas cocaine use in the periconceptional period was associated with the risk of cleft palate (2.5; 1.1–5.4). CONCLUSIONS:There were very few suggestions of positive associations between periconceptional illicit drug use and the 20 birth defects categories.
ISSN:1044-3983
1531-5487
DOI:10.1097/EDE.0b013e31818e5930