American Journal of Obstetrics and Gynecology
ResearchObstetricsMaternal corticosteroid use and orofacial clefts
Section snippets
Materials and Methods
This analysis included data on deliveries that occurred during or after October 1997 and that had estimated dates of delivery during or before December 2002 and were part of the National Birth Defects Prevention Study, a multistate case-control study of >30 different birth defects. This study was an approved activity of the institutional review boards of the participating study centers and the Centers for Disease Control and Prevention. Detailed study methods and descriptions of the
Results
We interviewed mothers of 1141 infants with CLP, 628 infants with CP, and 4143 control infants. Most mothers of control infants were non-Hispanic white (60%), attended college (58%), took folic acid-containing supplements (86%), and did not smoke (81%; Table 1). Mothers were relatively evenly distributed across the centers.
In total, mothers of 33 infants with CLP (2.9%), 6 infants with CP (1.0%), and 72 control infants (1.7%) reported any corticosteroid medication use during the 4 weeks before
Comment
In this study, maternal periconceptional corticosteroid use was associated with a moderately increased risk of CLP, but not CP. Most of the comparisons by route of administration and for specific component medications yielded ORs for CLP of ≥1.5; however, these comparisons had less precision than the overall results, because of smaller sample size. Only topical use was not associated with increased risk of CLP. All corticosteroid medications are associated with at least some systemic
Acknowledgment
Coding of drug information in the National Birth Defects Prevention Study used the Slone Epidemiology Center Drug Dictionary, under license from the Slone Epidemiology Center at Boston University.
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Supported by a cooperative agreement from the Centers for Disease Control and Prevention, Centers of Excellence Award No.U50/CCU913241.
Cite this article as: Carmichael SL, Shaw GM, Ma C, et al. Maternal corticosteroid use and orofacial clefts. Am J Obstet Gynecol 2007;197:585.e1-585.e7.