Using Nasal Decongestants in Pregnancy Increases Risks of Birth Defects

Using certain over -the- counter medications to treat nasal congestion during early pregnancy can place women at higher risks of having babies with birth defects, a study reveals.

Study author, Dr. Allen Mitchell and colleagues found that use of some common decongestants like phenylephrine and pseudoephedrine in the first trimester led to birth defects particularly related to the digestive tract, ear and heart in the babies, Reuters Health reported. 

The study included 12,734 babies with birth defects which compared them to 7,606 healthy infants. All the children affected with birth defects were part of the Slone Epidemiology Center Birth Defects Study, born in the United States and Canada between 1993 and 2010. All the mothers answered questions related to their pregnancy and the medications they used before and during pregnancy.

This study re-confirmed previous research papers that highlighted the risks associated with the use of phenylephrine and phenylpropanolamine in pregnancy, and added a new decongestant -pseudoephedrine- to the risk list.

While phenylephrine was associated with an eight times increased risk of heart defects (endocardial cushion defect), phenylpropanolamine (Acutrim) was tied to an eight-fold additional risk to defects in the ear and stomach.

Another decongestant, pseudoephedrine in early pregnancy increased limb reduction defects, by three times.  An ingredient used in nasal sprays and eye drops- imidazolines- more than doubled abnormalities in trachea and esophagus.

However, the researchers couldn't find any of these decongestant medications increasing the risks of clubfoot or eye/ face -related defects, cited by previous studies.

"The fact that medications such as decongestants are typically and widely available for use without a prescription and do not require consultation with a healthcare provider should not be assumed to mean they are safe with respect to the fetus, since there are still relatively few studies that examine the risks and relative safety of these 'over-the-counter' medications, which are more widely used in pregnancy than prescription medications," Dr. Mitchell, director of the Slone Epidemiology Center at Boston University, told Reuters Health.

The findings published in the American Journal of Epidemiology, come at a time when one in 33 babies in the U.S. is born with a birth defect. Following are some steps recommended by Centers for Disease Control and Prevention (CDC) that help pregnant women avoid risks of birth defects in babies:

• Never skip folic acid (400 mcg) medication in pregnancy
• Abstain from consuming alcohol
• Stop smoking
• Never use illegal drugs
• Take medicines only after consulting a medical practitioner and a gynaecologist
• Take extra precautions to avoid infections in pregnancy
• Learn about the safety and side-effects of vaccines in pregnancy. Take appropriate vaccinations that helps prevent infections in pregnancy
• Manage gestational diabetes
• Follow a healthy lifestyle and maintain healthy weight in pregnancy
• Make regular visits to the gynaecologist