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Am J Obstet Gynecol. 2014 Oct;211(4):404.e1-9. doi: 10.1016/j.ajog.2014.03.054. Epub 2014 Mar 27.

Case-control analysis of maternal prenatal analgesic use and cardiovascular malformations: Baltimore-Washington Infant Study.

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  • 1Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS. Electronic address:
  • 2National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), Atlanta, GA.
  • 3Rollins School of Public Health, Emory University, Atlanta, GA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS.



We sought to assess maternal prenatal use of analgesics and risk of cardiovascular malformations (CVM) in the offspring.


Data from the Baltimore-Washington Infant Study, a population-based case-control investigation of CVM, were used to examine selected isolated CVM diagnoses and maternal analgesic use during the periconceptional period (3 months before and after conception). We compared case and control infants on frequency of maternal use of analgesics and estimated adjusted odds ratios (adjORs) and 95% confidence intervals (CI) with logistic regression models for specific CVM phenotypes.


Frequency of periconceptional use of any analgesic was 52% among control mothers and 53% among case mothers. Analyses by CVM diagnoses identified an association of tetralogy of Fallot with maternal acetaminophen use (adjOR, 1.6; 95% CI, 1.1-2.3) and dextrotransposition of the great arteries with intact ventricular septum with maternal nonsteroidal antiinflammatory drug use (adjOR, 3.2; 95% CI, 1.2-8.7).


Analgesic use during the periconceptional period was not associated with CVM in the aggregate or with most phenotypes of CVM examined. Associations with 2 phenotypes of CVM may have occurred by chance. These findings warrant corroboration and further study, including further evaluation of the observed associations, the dose of analgesic taken, more specific timing of analgesic use, and indications for use.

Copyright © 2014 Elsevier Inc. All rights reserved.


analgesics; birth defects; cardiovascular malformations; congenital heart defects; pregnancy

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