Nasal Sprays, Used For Colds And Allergies, Increase Risk Of Birth Defects

For pregnant women, some ingredients found in common nasal sprays, decongestants typically used to treat the symptoms of colds and allergies, can increase the risk of rare birth defects.

A team at Boston University worked with a large collection of data on babies born with birth defects between 1993 and 2010. Using data from the Slone Epidemiology Center Birth Defects Study, researchers analyzed 12,734 infants with malformations and 7,606 non-malformed control infants in the United States and Canada.

Mothers of babies with non-genetically related birth defects were interviewed. They were asked about medications they took during pregnancy and in the two months prior to becoming pregnant.

Researchers determined using decongestant nasal sprays and oral medications that contain phenylephrine and phenylpropanolamine during the first trimester of pregnancy is especially concerning for the healthy development of offspring in utero.

Phenylephrine and phenylpropanolamine are commonly used by cold and hay-fever sufferers to alleviate nasal congestion.

Oral and intranasal (nasal sprays) decongestants containing the aforementioned ingredients were found to increase the risk of ear, heart, and digestive tract birth defects, reports Medical Daily.

First trimester use of phenylephrine was tied to an eight-fold higher risk of endocardial cushion defects. More commonly known as atrioventricular (AV) canal or septal defects, endocardial cushion defects include a range of developmental flaws affecting the atrial septum, the ventricular septum, and one or both of the AV valves of the heart, according to E-Medicine.

Phenylpropanolamine was linked to an eight-fold risk of defects of the ear and stomach. Researchers also found links between first trimester use of pseudoephedrine and limb defects.

Although the eight-fold increase in risk indicated by the study results sounds large, the numbers would translate to a 2.7 in 1,000 chance the baby would have the defect.

Use of imidazolines, found in nasal sprays and eye drops, was tied to a doubled of the risk of abnormal developments of the trachea and esophagus.

Study author Dr. Allen Mitchell was quoted in the Daily Mail saying, “Major birth defects of any kind affect about two to three percent of live born infants, so they are rare.” He further explained, “The associations we identified involved defects that generally affect less than 1 per 1,000 infants. Some of them may require surgery, but not all are life-threatening.”

Dr. Mitchell is the director of Slone Epidemiology Center at Boston University.

Based on the research, experts caution against the use of the aforementioned medications by pregnant women, unless instructed otherwise by their medical care provider.

Dr. Mitchell believes there’s enough evidence indicating a possible connection to birth defects that doctors should not be recommending that pregnant women take decongestants, but should evaluate each woman’s need for the drugs on a case-by-case basis.

“The risks we identified should be kept in perspective,'” Dr Mitchell cautioned. “The risk of an endocardial cushion defect among babies whose mothers did not take decongestants is about three per 10,000 live births.”

They found no link between the medications and several other deformities that had been suggested by previous studies, such as clubfoot or defects of the eye or face.

The link between nasal sprays and an increased risk of rare birth defects was published in the American Journal of Epidemiology.

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