Using Decongestants While Pregnant Linked to Birth Defects

If you’re pregnant and have allergies or a cold, you may want to think twice before popping a Sudafed, a new study says.

 Decongestants are among the most commonly used over-the-counter drugs, but a study by Dr. Allen Mitchell of the SloneEpidemiologyCenter at BostonUniversity found a link between using decongestants in the first trimester and some rare birth defects.

Dr. Mitchell and his research team studied data of babies born with birth defects between 1993 and 2010. They worked with nurses who interviewed mothers of 12,700 babies born with defects not caused by chromosome abnormalities and mothers of 7,600 fully healthy babies.

The interviews included questions about medications the mothers took while pregnant and in the two preceding months before getting pregnant, which Dr. Mitchell and his research team then compared.

Mothers who used phenylephrine, a leading component of decongestants, in the first trimester were linked to an 8x higher risk of a heart defect known as endocardial cushion defect (ECD). The National Institutes of Health’s Medline Plus explains that ECD is “an abnormal heart condition in which the walls separating all four chambers of the heart are poorly formed or absent.”

Additionally, the use of phenylpropanolamine, another component of decongestants, was linked to an 8x higher risk of ear defects and 3x higher risk of stomach defects.

The findings of these two drugs are supported by links found in previous studies as well.

In addition to these findings, the study also discovered new associations between pseudoephedrine (Sudafed) and 3x increased risk of limb reduction defects, where the limbs fail to grow completely.

Finally, the use of imidazolines (leading component of nasal decongestants and eye drops) was linked to a two-fold increase in risk for an abnormality connecting the trachea and esophagus.

However, Dr. Mitchell points out that the risk of these defects was still present in mothers who had not taken decongestants, including 3 per 10,000 live births for endocardial cushion defect, which would mean 24 cases per 10,000 for mothers who had used phenylephrine.

Since this still makes the defects rare even with the use of decongestants, Dr. Mitchell believes women should not stress if they have taken a decongestant while pregnant. However, this topic bears further research to be certain and this is still something pregnant women should consider in the meantime.