No association between severe constipation with related drug treatment in pregnant women and congenital abnormalities in their offspring: A population‐based case‐control study

Constipation is a common pathological condition in pregnant women; nevertheless, its possible association with structural birth defects (i.e. congenital abnormalities [CA]) in their offspring has not been studied in controlled epidemiological studies. We evaluated the possible association between severe constipation with laxative treatment in pregnant women and congenital abnormalities in their offspring. The dataset of the population‐based Hungarian Case‐Control Surveillance System of Congenital Abnormalities (HCCSCA) 1980–1996 contained 22 843 cases with CA and 38 151 matched controls without CA. Only pregnant women with prospectively and medically recorded constipation were included in the study and 13 CA groups were compared in cases and all their matched controls. A total of 78 (0.34%) cases had mothers with severe constipation and treatment during pregnancy compared to 144 (0.38%) controls (adjusted OR with 95% CI = 1.0, 0.7–1.3). Specified groups of CA were also assessed versus controls, but a higher occurrence of pregnant women with severe constipation and related treatment was not found in any CA group. Among laxative drugs, senna has no teratogenic potential; thus, if severe constipation requires laxative drug treatment in pregnant women, senna is not contraindicated. A higher rate of CA was not found in the offspring of pregnant women with severe constipation and related senna treatment.

[1]  V. Villanacci,et al.  A practical approach to diagnosis and management of functional constipation in adults , 2013, Internal and Emergency Medicine.

[2]  A. Czeizel,et al.  Sex ratio of newborn infants born to pregnant women with severe chronic constipation , 2010, Clinical epidemiology.

[3]  A. Czeizel,et al.  Senna treatment in pregnant women and congenital abnormalities in their offspring--a population-based case-control study. , 2009, Reproductive toxicology.

[4]  A. Czeizel,et al.  Phenolphthalein treatment in pregnant women and congenital abnormalities in their offspring: A population-based case-control study. , 2008, Drug discoveries & therapeutics.

[5]  E. Fagan Disorders of the Gastrointestinal Tract , 2008 .

[6]  F. Sauvat Diagnostic de la constipation chez l’enfant , 2007, Annales Nestlé (Ed. française).

[7]  F. Sauvat Diagnosis of Constipation in Children , 2007, Annales Nestlé (English ed.).

[8]  S. Kane,et al.  American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. , 2006, Gastroenterology.

[9]  J. Wolf,et al.  Therapy Insight: drugs for gastrointestinal disorders in pregnant women , 2006, Nature Clinical Practice Gastroenterology &Hepatology.

[10]  A. Czeizel,et al.  Periconceptional folic acid/multivitamin supplementation and twin pregnancy. , 2004, American journal of obstetrics and gynecology.

[11]  J. Erickson,et al.  Vitamin supplements and the risk for congenital anomalies other than neural tube defects , 2004, American journal of medical genetics. Part C, Seminars in medical genetics.

[12]  A. Berstad,et al.  Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting , 2003, Alimentary pharmacology & therapeutics.

[13]  A. Czeizel,et al.  Validation studies of drug exposures in pregnant women , 2003, Pharmacoepidemiology and drug safety.

[14]  C. Williamson,et al.  Drugs in pregnancy. Gastrointestinal disease. , 2001, Best practice & research. Clinical obstetrics & gynaecology.

[15]  Erika Varga,et al.  Description and mission evaluation of the Hungarian case-control surveillance of congenital abnormalities, 1980-1996. , 2001, Teratology.

[16]  D. Jewell,et al.  Interventions for treating constipation in pregnancy. , 2001, The Cochrane database of systematic reviews.

[17]  A. Czeizel First 25 years of the Hungarian congenital abnormality registry. , 1997, Teratology.

[18]  A. Czeizel Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. , 1996, American journal of medical genetics.

[19]  A. Czeizel,et al.  What proportion of congenital abnormalities can be prevented? , 1993, BMJ.

[20]  A. Czeizel,et al.  Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. , 1992, The New England journal of medicine.

[21]  D. Drossman,et al.  Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. , 1982, Gastroenterology.

[22]  Jon I. Isenberg American gastroenterological association , 2001 .

[23]  W. Dick,et al.  Gastrointestinal Disease , 1983, Treatment in Clinical Medicine.

[24]  S. Shapiro,et al.  Birth defects and drugs in pregnancy , 1977 .