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Most Pregnant Women Never Tested for the Most Common Birth Defect
 February 8th, 2010  
Three out of five women who have given birth to a child with a congenital heart defect (CHD) — the number-one birth defect and leading killer of infants and newborns — were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.
These findings come just as CHD Awareness Week begins (Feb. 7 – 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth — because the mothers were not tested for heart defects during pregnancy.
Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy — mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).
“Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested — and newborns are not routinely screened — for this defect,” says Lenore Cameron, President and Executive Director, Little Hearts, Inc. “Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives.”
Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:
- Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
- One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
- Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby’s arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy
More Survey Results
- Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
- Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
- Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
- Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
- The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely
There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.
Source
Related
- Most Pregnant Women Never Tested for the Most Common Birth Defect
Three out of five women who have given birth to a child with a congenital heart defect (CHD) — the number-one birth defect and leading killer of infants and newborns — were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.
These findings come just as CHD Awareness Week begins (Feb. 7 – 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth — because the mothers were not tested for heart defects during pregnancy.
Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy — mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).
“Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested — and newborns are not routinely screened — for this defect,” says Lenore Cameron, President and Executive Director, Little Hearts, Inc. “Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives.”
Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:
- Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
- One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
- Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby’s arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy
More Survey Results
- Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
- Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
- Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
- Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
- The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely
There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.
Source
- Antiseizure Drug Increases Birth Defect Risk
Using the antiseizure medication valproic acid (Depakote) in the first trimester of pregnancy significantly increased the risk of six types of birth defect, European researchers found.
In an analysis of more than 98,000 pregnancies, the risk of the serious spinal defect known as spina bifida was increased more than 12 times for children of mothers on the drug, according to Lolkje T.W. de Jong-van den Berg, of the University of Groningen in the Netherlands and colleagues.
The risks of another five defects were increased between two and seven times, the researchers reported in the June 10 issue of the New England Journal of Medicine.
Those findings support recommendations by the American Academy of Neurology to avoid the use of the drug in pregnancy, the researchers wrote. In the clinic, they continued, the risks of birth defects associated with valproic acid should be routinely considered in women of childbearing age.
Looking at past studies and comparing them against an antiepileptic-study database set up by the European Surveillance of Congenital Anomalies (EUROCAT), the researchers found that six malformations were significantly linked to a woman’s valproic acid use in her first trimester of pregnancy. In addition to spina bifida, the children of these women faced a more than doubled risk of a heart condition known as an atrial septal defect and a five-fold risk of cleft palate.
The risk of hypospadias — a condition in which the opening of the urethra in boys is on the underside of the penis rather than the end — went up nearly five times with a mother’s use of the drug. Craniosynostosis, a condition in which the bones of the skull close too early, was nearly seven times as common in these children, and polydactyly, a condition in which a child has more than five fingers per hand, was more than twice as common.
On the other hand, the researchers found, absolute risks of malformations remained low, ranging from 0.1 percent for craniosynostosis to 0.7 percent for hypospadias. The absolute risk for spina bifida associated with valproic acid was 0.6 percent, they found.
The researchers also cautioned that the study was observational, so it could not indicate anything about cause and effect. They were also unable to say anything about possible confounding by indication, since the drug is used for several clinical indications, or the effects of varying dosages.
Source
- Obesity in Pregnancy Ups Risk of Heart Defect in Baby
Obese pregnant women are at increased risk of having a baby with a congenital heart defect, a new study finds.
On average, obesity is associated with a 15 percent increased risk of having a baby with a heart defect. But the risk rises with the level of obesity. Compared to normal-weight women, the risk is 11 percent higher in moderately obese women and 33 percent higher in morbidly obese women.
In general, women who were overweight but not obese had no increased risk, said the researchers at the U.S. National Institute of Child Health and Human Development (NICHD) and the New York State Department of Health.
“The trend is unmistakable: the more obese a woman is, the more likely she is to have had a child with a heart defect,” study first author Dr. James L. Mills, of the NICHD’s Division of Epidemiology, Statistics and Prevention Research, said in a news release.
For this study, researchers compared the records of mothers of 7,392 children born with major heart defects and more than 56,000 mothers of infants born without birth defects. Because the study looked at the records of infants after they were born, it doesn’t conclusively prove that obese women who lose weight before becoming pregnant will reduce their risk of having a baby with a heart defect, the researchers noted.
However, “if a woman is obese, it makes sense for her to try to lose weight before becoming pregnant,” Mills said. “Not only will weight loss improve her own health and that of her infant, it is likely to have the added benefit of reducing the infant’s risk for heart defects.”
Source
- Herbal use common among pregnant women in U.S.
Roughly 1 in 10 pregnant women in the U.S. expose their unborn baby to herbal products, according to a new study.
This finding is potentially concerning, researchers say, given that data on the safety of herbal use during pregnancy is lacking. Furthermore, the prevalence of exposure was highest in the first 3 months of pregnancy, a critical period of development.
“If we assume that our study sample was representative of the 4.2 million births each year in the United States, our findings project that 9.4 percent, or potentially 395,000 U.S. births annually, will involve exposure to at least one herbal product during pregnancy,” lead author Dr. Cheryl S. Broussard, from the Centers for Disease Control and Prevention in Atlanta, told Reuters Health by email.
The findings, reported in the American Journal of Obstetrics and Gynecology, are based on data from 4,239 mothers in the National Birth Defects Prevention Study who delivered infants with no major birth defects from 1998 to 2004. The 10 study centers were located across the U.S.
Overall, 462 (10.9 percent) of the 4,239 mothers reported using herbal products in the 3 months before or at some point during pregnancy. The prevalence of herbal use anytime during pregnancy was 9.4 percent. The prevalence during pregnancy was highest (6.9 percent) during the first trimester.
Excluding the 86 mothers whose only use of herbs involved herbal teas, the prevalence of herb exposure before or during pregnancy was 8.9 percent.
The most commonly reported products used early in pregnancy were ginger, which has been shown to help ease morning sickness, without side effects to the unborn child, and ephedra, an herbal stimulant that was banned in the U.S. in 2004 after reports linked it to heart attacks, strokes and at least 155 deaths.
The products used most often throughout pregnancy were herbal teas and chamomile, which has also been shown to ease morning sickness.
Herb exposure was more prevalent in women older than 30 and with more than 12 years of education. Of the 10 states studied, Iowa had the lowest rate of herbal use (5.4 percent) and Utah had the highest (16.5 percent).
“The fact that use of herbal products was greatest during the first trimester raises concerns about fetal safety, because this is a critical period of fetal organ development,” Broussard noted.
“Providers should inform patients that it would be prudent to err on the side of caution regarding use of herbal products just before and during pregnancy because little is known about their potential risks.”
Source
- Migraine drugs don’t up birth defect risk: study
A study in nearly 70,000 pregnant women has found no link between migraine drugs called triptans and the risk of birth defects.
However, the researchers did find a “slight increase” in the risk of excessive bleeding during labor, and the failure of the uterus to contract normally after delivery, for women who used the drugs while pregnant.
Triptans are among the most powerful drugs used for migraine; others include aspirin, Excedrin, and ibuprofen.
While as many as three in 10 women may develop migraines during their childbearing years, women often shy away from using such drugs during pregnancy because of safety concerns, according to study co-author Katerina Nezvalova-Henriksen of the University of Oslo in Norway and her colleagues.
However, the authors of the study in Headache note, untreated migraine may itself carry risks for mother and child; some studies have linked it to pre-eclampsia, a potentially deadly pregnancy complication.
“While it is important to exert caution when using any medications during pregnancy, this study indicates” that pregnant women can either start or continue taking triptans without “any major risk” of miscarriage, premature delivery, or other bad outcomes, the authors conclude.
Nezvalova-Henriksen and her team studied nearly 70,000 women. Two percent, or 1,535, had used sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or eletriptan (Relpax) in pregnancy.
Less than one percent — 373 women — had used the drugs before getting pregnant but not during pregnancy.
The overall birth defect rate, which encompasses everything from large birthmarks to serious heart problems, was the same among women who had taken triptans during pregnancy and those who didn’t have migraines: 5 percent. Among those who had used triptans in the past but not during pregnancy, it was slightly higher: 6 percent.
The women who used triptans were also more likely than non-triptan users to take other drugs during pregnancy, including acetaminophen (Tylenol) with codeine and non-steroidal anti-inflammatory drugs such as ibuprofen.
However, the rate of major birth defects – such as serious problems of the limbs or internal organs — was 3 percent for all three groups. That rate – about one in 33 births – is about what would be expected for all birth defects in the general population.
The researchers did find that women who used triptans in their second or third trimester were more likely to develop a condition called atonic uterus, in which the uterus fails to contract back to its normal size after delivery. This is the leading cause of excessive bleeding after delivery. They were also more likely to lose significant amounts of blood during labor and delivery.
And during pregnancy, they were more likely to suffer from vomiting than women who had never used the drug; they were also more likely to develop pre-eclampsia or eclampsia, and more likely to have deficiencies in the B-vitamin folate.
While many women who suffer migraines will experience improvements in their symptoms after their first trimester, Nezvalova-Henriksen and her team note, those whose symptoms don’t improve by then aren’t likely to get better.
Source
Most Pregnant Women Never Tested for the Most Common Birth Defect
February 8th, 2010
Three out of five women who have given birth to a child with a congenital heart defect (CHD) — the number-one birth defect and leading killer of infants and newborns — were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.
These findings come just as CHD Awareness Week begins (Feb. 7 – 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth — because the mothers were not tested for heart defects during pregnancy.
Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy — mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).
“Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested — and newborns are not routinely screened — for this defect,” says Lenore Cameron, President and Executive Director, Little Hearts, Inc. “Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives.”
Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:
- Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
- One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
- Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby’s arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy
More Survey Results
- Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
- Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
- Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
- Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
- The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely
There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.
Source
Related
- Most Pregnant Women Never Tested for the Most Common Birth Defect
Three out of five women who have given birth to a child with a congenital heart defect (CHD) — the number-one birth defect and leading killer of infants and newborns — were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.
These findings come just as CHD Awareness Week begins (Feb. 7 – 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth — because the mothers were not tested for heart defects during pregnancy.
Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy — mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).
“Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested — and newborns are not routinely screened — for this defect,” says Lenore Cameron, President and Executive Director, Little Hearts, Inc. “Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives.”
Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:
- Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
- One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
- Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby’s arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy
More Survey Results
- Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
- Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
- Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
- Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
- The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely
There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.
Source
- Antiseizure Drug Increases Birth Defect Risk
Using the antiseizure medication valproic acid (Depakote) in the first trimester of pregnancy significantly increased the risk of six types of birth defect, European researchers found.
In an analysis of more than 98,000 pregnancies, the risk of the serious spinal defect known as spina bifida was increased more than 12 times for children of mothers on the drug, according to Lolkje T.W. de Jong-van den Berg, of the University of Groningen in the Netherlands and colleagues.
The risks of another five defects were increased between two and seven times, the researchers reported in the June 10 issue of the New England Journal of Medicine.
Those findings support recommendations by the American Academy of Neurology to avoid the use of the drug in pregnancy, the researchers wrote. In the clinic, they continued, the risks of birth defects associated with valproic acid should be routinely considered in women of childbearing age.
Looking at past studies and comparing them against an antiepileptic-study database set up by the European Surveillance of Congenital Anomalies (EUROCAT), the researchers found that six malformations were significantly linked to a woman’s valproic acid use in her first trimester of pregnancy. In addition to spina bifida, the children of these women faced a more than doubled risk of a heart condition known as an atrial septal defect and a five-fold risk of cleft palate.
The risk of hypospadias — a condition in which the opening of the urethra in boys is on the underside of the penis rather than the end — went up nearly five times with a mother’s use of the drug. Craniosynostosis, a condition in which the bones of the skull close too early, was nearly seven times as common in these children, and polydactyly, a condition in which a child has more than five fingers per hand, was more than twice as common.
On the other hand, the researchers found, absolute risks of malformations remained low, ranging from 0.1 percent for craniosynostosis to 0.7 percent for hypospadias. The absolute risk for spina bifida associated with valproic acid was 0.6 percent, they found.
The researchers also cautioned that the study was observational, so it could not indicate anything about cause and effect. They were also unable to say anything about possible confounding by indication, since the drug is used for several clinical indications, or the effects of varying dosages.
Source
- Obesity in Pregnancy Ups Risk of Heart Defect in Baby
Obese pregnant women are at increased risk of having a baby with a congenital heart defect, a new study finds.
On average, obesity is associated with a 15 percent increased risk of having a baby with a heart defect. But the risk rises with the level of obesity. Compared to normal-weight women, the risk is 11 percent higher in moderately obese women and 33 percent higher in morbidly obese women.
In general, women who were overweight but not obese had no increased risk, said the researchers at the U.S. National Institute of Child Health and Human Development (NICHD) and the New York State Department of Health.
“The trend is unmistakable: the more obese a woman is, the more likely she is to have had a child with a heart defect,” study first author Dr. James L. Mills, of the NICHD’s Division of Epidemiology, Statistics and Prevention Research, said in a news release.
For this study, researchers compared the records of mothers of 7,392 children born with major heart defects and more than 56,000 mothers of infants born without birth defects. Because the study looked at the records of infants after they were born, it doesn’t conclusively prove that obese women who lose weight before becoming pregnant will reduce their risk of having a baby with a heart defect, the researchers noted.
However, “if a woman is obese, it makes sense for her to try to lose weight before becoming pregnant,” Mills said. “Not only will weight loss improve her own health and that of her infant, it is likely to have the added benefit of reducing the infant’s risk for heart defects.”
Source
- Herbal use common among pregnant women in U.S.
Roughly 1 in 10 pregnant women in the U.S. expose their unborn baby to herbal products, according to a new study.
This finding is potentially concerning, researchers say, given that data on the safety of herbal use during pregnancy is lacking. Furthermore, the prevalence of exposure was highest in the first 3 months of pregnancy, a critical period of development.
“If we assume that our study sample was representative of the 4.2 million births each year in the United States, our findings project that 9.4 percent, or potentially 395,000 U.S. births annually, will involve exposure to at least one herbal product during pregnancy,” lead author Dr. Cheryl S. Broussard, from the Centers for Disease Control and Prevention in Atlanta, told Reuters Health by email.
The findings, reported in the American Journal of Obstetrics and Gynecology, are based on data from 4,239 mothers in the National Birth Defects Prevention Study who delivered infants with no major birth defects from 1998 to 2004. The 10 study centers were located across the U.S.
Overall, 462 (10.9 percent) of the 4,239 mothers reported using herbal products in the 3 months before or at some point during pregnancy. The prevalence of herbal use anytime during pregnancy was 9.4 percent. The prevalence during pregnancy was highest (6.9 percent) during the first trimester.
Excluding the 86 mothers whose only use of herbs involved herbal teas, the prevalence of herb exposure before or during pregnancy was 8.9 percent.
The most commonly reported products used early in pregnancy were ginger, which has been shown to help ease morning sickness, without side effects to the unborn child, and ephedra, an herbal stimulant that was banned in the U.S. in 2004 after reports linked it to heart attacks, strokes and at least 155 deaths.
The products used most often throughout pregnancy were herbal teas and chamomile, which has also been shown to ease morning sickness.
Herb exposure was more prevalent in women older than 30 and with more than 12 years of education. Of the 10 states studied, Iowa had the lowest rate of herbal use (5.4 percent) and Utah had the highest (16.5 percent).
“The fact that use of herbal products was greatest during the first trimester raises concerns about fetal safety, because this is a critical period of fetal organ development,” Broussard noted.
“Providers should inform patients that it would be prudent to err on the side of caution regarding use of herbal products just before and during pregnancy because little is known about their potential risks.”
Source
- Migraine drugs don’t up birth defect risk: study
A study in nearly 70,000 pregnant women has found no link between migraine drugs called triptans and the risk of birth defects.
However, the researchers did find a “slight increase” in the risk of excessive bleeding during labor, and the failure of the uterus to contract normally after delivery, for women who used the drugs while pregnant.
Triptans are among the most powerful drugs used for migraine; others include aspirin, Excedrin, and ibuprofen.
While as many as three in 10 women may develop migraines during their childbearing years, women often shy away from using such drugs during pregnancy because of safety concerns, according to study co-author Katerina Nezvalova-Henriksen of the University of Oslo in Norway and her colleagues.
However, the authors of the study in Headache note, untreated migraine may itself carry risks for mother and child; some studies have linked it to pre-eclampsia, a potentially deadly pregnancy complication.
“While it is important to exert caution when using any medications during pregnancy, this study indicates” that pregnant women can either start or continue taking triptans without “any major risk” of miscarriage, premature delivery, or other bad outcomes, the authors conclude.
Nezvalova-Henriksen and her team studied nearly 70,000 women. Two percent, or 1,535, had used sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or eletriptan (Relpax) in pregnancy.
Less than one percent — 373 women — had used the drugs before getting pregnant but not during pregnancy.
The overall birth defect rate, which encompasses everything from large birthmarks to serious heart problems, was the same among women who had taken triptans during pregnancy and those who didn’t have migraines: 5 percent. Among those who had used triptans in the past but not during pregnancy, it was slightly higher: 6 percent.
The women who used triptans were also more likely than non-triptan users to take other drugs during pregnancy, including acetaminophen (Tylenol) with codeine and non-steroidal anti-inflammatory drugs such as ibuprofen.
However, the rate of major birth defects – such as serious problems of the limbs or internal organs — was 3 percent for all three groups. That rate – about one in 33 births – is about what would be expected for all birth defects in the general population.
The researchers did find that women who used triptans in their second or third trimester were more likely to develop a condition called atonic uterus, in which the uterus fails to contract back to its normal size after delivery. This is the leading cause of excessive bleeding after delivery. They were also more likely to lose significant amounts of blood during labor and delivery.
And during pregnancy, they were more likely to suffer from vomiting than women who had never used the drug; they were also more likely to develop pre-eclampsia or eclampsia, and more likely to have deficiencies in the B-vitamin folate.
While many women who suffer migraines will experience improvements in their symptoms after their first trimester, Nezvalova-Henriksen and her team note, those whose symptoms don’t improve by then aren’t likely to get better.
Source
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