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Birth defect linked to decongestant drug.

If Mom takes an over-the-counter decongestant during the first trimester of pregnancy, she may increase the risk of delivering a baby with a type of abdominal defect, according to a preliminary new study.

Nobody really understands the cause of gastroschisis, a hole in the abdominal wall that allows the baby's intestines to protrude outside its body. Although the defect is rare, epidemiologists have noted a rise in the number of cases reported during the last three decades. That fact, along with the clue that young women are more likely to deliver a baby with this defect, raised the possibility that an environmental factor plays a role in the development of gastroschisis.

A team of epidemiologists decided to delve into the mystery. Martha M. Werler and her colleagues at Boston University School of Public Health in Brookline, Mass., began by looking at data gathered in an ongoing birth defect study that began in 1976. They analyzed data from 76 cases of gastroschisis as well as 2,142 controls who had other types of birth defects such as cleft lip. The data included interviews with new mothers, who were asked whether they had taken any drugs during pregnancy, including a common decongestant called pseudoephedrine.

Analysis revealed that women who had taken pseudoephedrine during the first trimester of pregnancy had a three-fold greater risk of delivering a baby with gastroschisis than women who had not taken this drug -- a statistically significant finding. "If such an association is real, it could have very serious public health implications," Werler told Science News.

Many obstetricians advise pregnant women to stay away from all drugs, even over-the-counter medications, during pregnancy. However, the danger from pseudoephedrine may arise early in gestation, before a woman realizes she is pregnant, Werler notes. Because pseudoephedrine products are sold in drugstores and supermarkets, people view them as a harmless way to treat the sniffles. The drug can be purchased in tablet form and is included in a wide variety of cold, flu and hay fever medications.

For most people, the drug's safety is not disputed. However, its impact on the developing baby has not been adequately studied, Werler says.

The study finds a potentially worrisome trend among women of childbearing age: a rising use of pseudoephedrine. While 2 percent of all new mothers interviewed from 1976 to 1978 reported using pseudoephedrine during pregnancy, 7 percent of those interviewed between 1988 to 1990 said they used the drug during pregnancy. The researchers report their data in the April Teratology.

Further research must be undertaken to ensure that the association is not due to chance, comments Richard K. Miller, an obstetrician at the University of Rochester (N.Y.) who wrote an editorial accompanying the Boston team's report.

Because the link between pseudoephedrine and gastroschisis is unproved, the authors remain cautious about drawing any conclusions from their preliminary findings. Werler says they cannot rule out the possibility that the drug is a marker for something else; perhaps an underlying condition such as the flu actually caused the abdominal wall defect, she says.
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Title Annotation:gastroschisis, pseudoephedrine
Author:Fackelmann, Kathy A.
Publication:Science News
Date:Apr 25, 1992
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