OBJECTIVE: To study human teratogenic potential of two trimethoprim-sulfonamide combinations: trimethoprim-sulfamethoxazole (cotrimoxazole) and trimethoprim-sulfamethazine during pregnancy. These agents have antifolate effects and other antifolate agents can induce multiple congenital abnormalities, neural-tube defects, cardiovascular, and other malformations in animal experiments and in humans. DESIGN: Pair analysis of cases with congenital abnormalities and matched healthy controls in the large population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. PARTICIPANTS: 38,151 pregnant women who had newborn infants without any congenital abnormalities (control group) and 22,865 case pregnant women who had newborns or fetuses with congenital abnormalities. MAIN OUTCOME: Prevalence of drug use in matched case-control pairs to study the possible association with congenital abnormalities. RESULTS: In the case group 351 (1.5%) and in the control group 443 (1.2%) pregnant women were treated with cotrimoxazole (crude OR 1.3 with 95% CI 1.1-1.5). In addition 45 (0.2%) case and 39 (0.1%) control pregnant women had trimethoprim-sulfamethazine treatment (crude OR 1.9 with 95% CI 1.3-3.0). A higher rate of multiple congenital abnormalities (including mainly urinary tract and cardiovascular abnormalities) was found in case infants born to mothers with cotrimoxazole treatment during the second-third months of pregnancy. In addition, a higher rate of cardiovascular malformations occurred in cases born to mothers with cotrimoxazole treatment and trimethoprim-sulfamethazine treatment during the second-third months of pregnancy, respectively. CONCLUSION: Treatment with cotrimoxazole during pregnancy may increase the risk of cardiovascular malformations, and particularly multiple congenital abnormalities including defects of the urinary tract and cardiovascular system. A higher rate of cardiovascular malformations was also found after treatment with trimethoprim-sulfamethazine in the second-third months of pregnancy.
OBJECTIVE: To study human teratogenic potential of two trimethoprim-sulfonamide combinations: trimethoprim-sulfamethoxazole (cotrimoxazole) and trimethoprim-sulfamethazine during pregnancy. These agents have antifolate effects and other antifolate agents can induce multiple congenital abnormalities, neural-tube defects, cardiovascular, and other malformations in animal experiments and in humans. DESIGN: Pair analysis of cases with congenital abnormalities and matched healthy controls in the large population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. PARTICIPANTS: 38,151 pregnant women who had newborn infants without any congenital abnormalities (control group) and 22,865 case pregnant women who had newborns or fetuses with congenital abnormalities. MAIN OUTCOME: Prevalence of drug use in matched case-control pairs to study the possible association with congenital abnormalities. RESULTS: In the case group 351 (1.5%) and in the control group 443 (1.2%) pregnant women were treated with cotrimoxazole (crude OR 1.3 with 95% CI 1.1-1.5). In addition 45 (0.2%) case and 39 (0.1%) control pregnant women had trimethoprim-sulfamethazine treatment (crude OR 1.9 with 95% CI 1.3-3.0). A higher rate of multiple congenital abnormalities (including mainly urinary tract and cardiovascular abnormalities) was found in case infants born to mothers with cotrimoxazole treatment during the second-third months of pregnancy. In addition, a higher rate of cardiovascular malformations occurred in cases born to mothers with cotrimoxazole treatment and trimethoprim-sulfamethazine treatment during the second-third months of pregnancy, respectively. CONCLUSION: Treatment with cotrimoxazole during pregnancy may increase the risk of cardiovascular malformations, and particularly multiple congenital abnormalities including defects of the urinary tract and cardiovascular system. A higher rate of cardiovascular malformations was also found after treatment with trimethoprim-sulfamethazine in the second-third months of pregnancy.
Authors: Nana O Wilson; Fatou K Ceesay; Samuel A Obed; Andrew A Adjei; Richard K Gyasi; Patricia Rodney; Yassa Ndjakani; Winston A Anderson; Naomi W Lucchi; Jonathan K Stiles Journal: Am J Trop Med Hyg Date: 2011-07 Impact factor: 2.345
Authors: Regina M Simeone; Sarah C Tinker; Suzanne M Gilboa; A J Agopian; Matthew E Oster; Owen J Devine; Margaret A Honein Journal: Ann Epidemiol Date: 2016-10-26 Impact factor: 3.797
Authors: Craig Hansen; Susan E Andrade; Heather Freiman; Sascha Dublin; Katie Haffenreffer; William O Cooper; T Craig Cheetham; Sengwee Toh; De-Kun Li; Marsha A Raebel; Jennifer L Kuntz; Nancy Perrin; A Gabriela Rosales; Shelley Carter; Pamala A Pawloski; Elizabeth M Maloney; David J Graham; Leyla Sahin; Pamela E Scott; John Yap; Robert Davis Journal: Pharmacoepidemiol Drug Saf Date: 2015-11-24 Impact factor: 2.890