Australian Birth Defects Society

A Society devoted to the study of birth defects

Quick round-up of interesting articles that have passed my desk this month.

Journal Club

December 2017

The American College of Ob and Gynae have released a committee opinion of Sulfonamides, Nitrofurantoin and Birth Defects.

This updated review recommends the continued prescribing of sulfonamides or nitrofurantoin in the first trimester when no other suitable alternative antibiotics are available.

Also recently updated are Guidelines for

· Diagnostic imaging

· Marijuana use

· Smoking cessation

· Immunization


Comparative safety of anti-epileptic drugs during pregnancy: a systematic review and network meta-analysis of congenital malformations and prenatal outcomes. BMC Medicine (2017) 15:95.

A handy systematic review of AED exposure data during pregnancy.


Birth defects after use of antithyroid drugs in early pregnancy: a Swedish nationwide study . Eur J Endocrinol 177, 369–378.

The population-based study included 162 babies with early pregnancy exposure to methimazole and 218 to propylthiouracil and 66 to both. Finding no significant increase in birth defects. Sub-group analysis revealed an increased incidence of ASD following methimazole exposure. The overall frequency of sever malformation swas low in line with the low exposure rate perhaps due to the restriction of the study to live births.


Human teratogens and genetic phenocopies.  Understanding pathogenesis through human genes mutation. Eur J Med Gen 60 (2017) 22e31.

Genetic phenocopies of drug-induced embryopathies can make counselling problematic. This paper reviews our current understanding of proposed mechanisms of teratogenic action by examining human geteic disorders.

October 2017

Page updated 6 October 2017

Is it safe to use lamotrigine during pregnancy? A prospective comparative observational study

Birth Def Res 109: 1196-1203 (2017)

Evaluation study of the rate of major anomalies after lamotrigine exposure during pregnancy compared with pregnancies of women counseled for nonteratogenic exposure using prospective follow-up of callers to the Israeli Teratology Information Service between 1997 and 2008. The rate of major congenital anomalies was similar between 218 lamotrigine exposed pregnancies (208 in the first trimester) and 865 NTE-pregnancies with no cases of oral cleft in the lamotrigine-exposed group.

Major Birth Defects after Vaccination Reported to the Vaccine Adverse Event Reporting System (VAERS), 1990 to 2014.Birth Defects Res. 109:1057-1062 (2017)

Report of a postmarketing surveillance of the presenceof major birthdefects following vaccination to the spontaneous reporting Vaccine Adverse Event Reporting System from 1990 to 2014. We Birth defects from vaccines to HPV, varicella, measles/mumps/rubella, and anthrax vaccines were excluded.  Of 50 reports of major birth defects; in 28 reports, the vaccine was given during the first trimester. Birth defects accounted for 3.2% of pregnancy reports with no unusual clusters or specific birth defects.

The Ribavirin Pregnancy Registry: An Interim Analysis of Potential Teratogenicity at the Mid-Point of Enrollment. Drug Saf. 40:1205-1218 (2017)

Ribavirin is associated with significant teratogenic effects in all animal species and is contraindicated in women who are pregnant and male partners of pregnant women. Since 2003, the Ribavirin Pregnancy registry birth defect cases have been recorded for 7/85 directly exposed women (8.2%) and 4/95 indirectly exposed women (4.2%). With no consistent patterns. Thus, preliminary findings do not suggest a clear signal of human teratogenicity for ribavirin although current sample size is insufficient to change current guidelines.