Decongestant use has no ill effects in pregnancy

NEW YORK (Reuters Health) - Women who take decongestants during pregnancy don't appear to risk having poor outcomes or to be putting their baby at risk for birth defects, a Swedish team reports.

A runny nose during pregnancy -- so-called pregnancy rhinitis -- "is a rather common complaint." Dr. Bengt A. J. Kallen, of the University of Lund, and colleagues write in the American Journal of Obstetrics and Gynecology. There has been some concern that treating the problem with decongestants may have a negative impact on fetal development.

To investigate, Kallen's group assessed outcomes in 2474 women who had used oral decongestants (mostly phenylpropanolamine) during early pregnancy and 1771 women who were given prescription oral decongestants later in pregnancy.

A total of 117 infants (4.7 percent) born after first-trimester exposure to decongestants had a congential malformation. That compares with 121 babies expected to be born with birth defects among the same number of women in the general population, the researchers report.

Women who were given prescription decongestants later in pregnancy actually had a decreased risk for preterm delivery of 32 percent, and a 47 percent decreased risk of having a low birth weight infant.

Also, the number of infants who died around the time of birth was 47 percent less among mothers prescribed decongestants after the first prenatal visit.

The cause of pregnancy rhinitis is not known, but hormones produced by the placenta are though to be involved. The apparently protective effect of oral decongestants on pregnancy outcomes may actually be a reflection of pregnancy rhinitis being "a sign of a well-functioning placenta," Kallen and colleagues suggest.

SOURCE: American Journal of Obstetrics and Gynecology, February 2006.