ArticleBirth defects research2021
Periconceptional nonsteroidal anti-inflammatory drug use, folic acid intake, and the risk of spina bifida.
Article in Birth defects research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Birth prevalence and determinants of neural tube defects among newborns in Ethiopia: A systematic review and meta-analysis.PloS one · 2025Pooled it
- First-trimester nonsteroidal anti-inflammatory drugs exposure and risk of major congenital malformations: A retrospective register-based cohort study.PLoS medicine · 2026Article
- The burden of neural tube defects in Southern Ethiopia: trends, hotspots, and public health implications.PeerJ · 2026Article
- Review
- Real-world data are not always big data: the case for primary data collection on medication use in pregnancy in the context of birth defects research.American journal of epidemiology · 2024Article
- Sulindac selectively induces autophagic apoptosis of GABAergic neurons and alters motor behaviour in zebrafish.Nature communications · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUse of nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy may increase risk for neural tube defects (NTDs), including spina bifida. Folic acid intake can prevent NTDs, but it is not known whether it modifies any risks associated with NSAID use.
objectivesTo assess the impact of periconceptional NSAID use on the risk of spina bifida overall and stratified by folic acid intake. STUDY
designWe analyzed 1998-2015 data from the Slone Epidemiology Center Birth Defects Study, a multi-site, case-control study. Mothers were interviewed to identify sociodemographic factors, behaviors, and exposures during pregnancy. Periconceptional NSAID use was defined as use of aspirin, ibuprofen, naproxen, or COX2 inhibitors within the month before or after the last menstrual period. Logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for NSAID use, adjusted for study center and race/ethnicity stratified by average daily folic acid intake above ("high FA") or below ("low FA") 400 mcg/day.
resultsWe compared mothers of 267 infants with spina bifida to mothers of 6,233 nonmalformed controls. Among control mothers, 20% used NSAIDS periconceptionally (16% ibuprofen, 4% aspirin, 3% naproxen, and <1% COX-2 inhibitors). For any NSAID use, the aORs among low FA and high FA women were 1.70 (95% CI [1.13, 2.57]) and 1.09 (95% CI [0.69, 1.71]), respectively.
conclusionsWe observed a small increase in the risk for spina bifida among infants born to women who used NSAIDs periconceptionally, but this risk was limited to those who had inadequate folic acid intake.
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