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Robin Elise Weiss, LCCE

Decongestants Increase the Risk of Certain Birth Defects

By July 24, 2013

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Sick Pregnant Woman

Decongestants are medications used to dry up your sinuses, like phenylephrine and psuedoephedrine. These are found in some oral and intranasal decongestants, like Sudafed, found over the counter in nearly any drug store. This means you may not even think twice about taking these medications or might not think to ask your doctor or midwife before using it. But multiple studies have looked at the use of these decongestants, particularly in the first trimester, and have found a variety of birth defects that are related to their use.

Some of the birth defects effected the baby's heart or limbs, others caused issues like pyloric stenosis. Either way, the risk of having baby with a major birth defect is about 2-3% of all pregnancies. This study estimated that some of the risks increased eight fold, depending on the medication and the timing. Here's the trick to deciding whether or not to take an over the counter medication in pregnancy - don't. Talk to your practitioner first. Ask what pregnancy category the medication is in to look at potential safety concerns.  Look at what the alternatives are for your condition. An example for the need to use a nasal decongestant might be a humidifier, saline nasal spray or even a neti pot. If after looking at all this information, you and your practitioner decide that the risks are outweighed by the benefits, you have an answer.

Also realize that timing plays a huge role in what harm is brought to a pregnancy by anything. The first trimester is a known sensitive period and everything about your baby is growing and changing.  There are typically fewer risks to many medications after the first trimester. This is not true of everything, but as a general rule.

What medication decisions have you had to make in pregnancy?

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Yau WP, Mitchell AA, Lin KJ, Werler MM, Hernández-Díaz S. Use of decongestants during pregnancy and the risk of birth defects. Am J Epidemiol. 2013.

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