Evidence map›Paper›PMID 27172856›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2016

Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy - a cohort linkage study.

E Garne, A Vinkel Hansen, J Morris, S Jordan, K Klungsøyr, A Engeland, D Tucker, D S Thayer, G I Davies, A-M Nybo Andersen and 1 more

Open access · hybridAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Association of maternal asthma with congenital heart defects in offspring.Acta obstetricia et gynecologica Scandinavica · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 3 countries.

E GarnePaediatric Department, Hospital Lillebaelt -Kolding, Kolding, Denmark.
A Vinkel HansenPaediatric Department, Hospital Lillebaelt -Kolding, Kolding, Denmark.
J MorrisDepartment Preventive Medicine, Wolfson Institute Preventive Medicine, Queen Mary University of London, London, UK.
S JordanCollege of Human & Health Science, University of Swansea, Swansea, Wales, UK.
K KlungsøyrMedical Birth Registry of Norway, Norwegian Institute of Public Health and Department of Global Health and Primary Care, University of Bergen, Bergen, Norway.
A EngelandMedical Birth Registry of Norway, Norwegian Institute of Public Health and Department of Global Health and Primary Care, University of Bergen, Bergen, Norway.
D TuckerCongenital Anomaly Register and Information Service for Wales, Health Intelligence Division, Public Health Wales, Swansea, UK.
D S ThayerCollege of Human & Health Science, University of Swansea, Swansea, Wales, UK.
G I DaviesCollege of Human & Health Science, University of Swansea, Swansea, Wales, UK.
A-M Nybo AndersenDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark.
H DolkUlster University, Londonderry, UK.
Swansea University · GBKolding Hospital · DKNorwegian Institute of Public Health · NOPublic Health Wales · GBQueen Mary University of London · GBUniversity of Copenhagen · DKUniversity of Ulster · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.

designMeta-analysis of aggregated data from three cohort studies.

settingLinkage between healthcare databases and EUROCAT congenital anomaly registries. POPULATION: 519 242 pregnancies in Norway (2004-2010), Wales (2000-2010) and Funen, Denmark (2000-2010).

methodsExposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.

main outcome measuresORs for all congenital anomalies and specific congenital anomalies.

resultsOverall exposure prevalence was 3.76%. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99% CI 1.09-1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99% CI 1.15-10.04). For severe congenital heart defects, an increased OR (1.97; 1.12-3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20-4.67).

conclusionThe increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken. TWEETABLE ABSTRACT: This cohort study found a small increased risk of congenital anomalies for women taking asthma medication.

Indexed as

Pregnancy Trimester, FirstResearch DesignAbnormalities, Drug-InducedAcute Kidney InjuryAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsAdultAerosolsAnti-Asthmatic AgentsAnus, ImperforateAsthmaCohort StudiesDenmarkFemaleHeart Defects, CongenitalHumansAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsAerosolsAnti-Asthmatic AgentsAsthma medicationcongenital anomaliesfirst trimester exposureinhaled beta-2 agonistsinhaled corticosteroids

Identifiers

PMID27172856
PMCPMC5084768
OpenAlexW2362928843

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.