Decongestant Use during Pregnancy and Its Association with Preterm Delivery

BACKGROUND: Despite the frequent intake of decongestants during pregnancy, only one study to date has evaluated the association of decongestants with preterm delivery, and it identified a reduced risk. We examined this association in more detail. METHODS: Using a population-based random sample of 3271 Massachusetts live-born births without major malformations, we categorized decongestant exposure according to timing, frequency of use, route, and indication. Preterm birth was defined as a gestational age of <37 completed weeks. We estimated hazard ratios and examined confounding by indication by examining various strata of women and through multivariate adjustment. RESULTS: Compared to nonexposed women, those who took decongestants during the second or third trimester only were less likely to experience preterm delivery (HR, 0.42; 95% CI, 0.21-0.84). This association was observed only for women without preeclampsia. CONCLUSIONS: A protective association between decongestant use and preterm delivery has now been observed in two studies; however, the possibility of confounding by underlying condition remains. Birth Defects Research (Part A) 88:715-721, 2010. (C) 2010 Wiley-Liss, Inc.