Skip to main content
SpringerLink
Log in

Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India

  • Original Research Article
  • Published:
Drug Safety Aims and scope Submit manuscript

Abstract

Introduction

Congenital malformations (CMFs) are a major public health problem in India. Consanguineous marriages, infections during pregnancy, folic acid deficiency during the periconceptional period, exposure to pesticides and a history of intake of drugs during pregnancy have been hypothesized as risk factors. Drugs include oral contraceptive pills, progesterone analogues, medications for ailments and indigenous drugs to bear male offspring. It is important to analyze the risk factors in order to implement preventive measures. The prime objective of this study was to study the risk factors of visible structural CMFs, with a focus on indigenous medicines for sex selection.

Methods

A population-based, case-control study was undertaken in Haryana state. Cases included children (0–18 months) with any apparent structural deformity as reported by various Government sources. A consecutive birth from the same area as the case was labelled and included as the control. The sample size calculated was 175 in each group. Mothers of every case and control were interviewed at their respective homes using a structured tool. Descriptive analysis, bivariate analysis, followed by logistic regression was conducted to establish the association between risk factors and CMFs.

Results

The sociodemographic profiles of the cases and controls were similar. Among the various risk factors studied, more than two living children (unadjusted odds ratio [OR] 1.6, 95 % CI 1.04–2.4) and intake of sex-selection drugs (unadjusted OR 2.8, 95 % CI 1.6–5.1) were significant risk factors on bivariate and regression analyses. The risk of having a child with CMFs was threefold more among mothers with a history of intake of indigenous medicines for sex selection (adjusted OR 3; 95 % CI 1.7–5.6).

Conclusions

The intake of indigenous drugs during pregnancy increased the risk of CMFs almost threefold. This has social as well as economic implications, and hence needs further investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. World Health Organization. Congenital anomalies. Geneva: World Health Organization; 2014.

    Google Scholar 

  2. Rosano A, Botto LD, Botting B, Mastroiacovo P. Infant mortality and congenital anomalies from 1950 to 1994: an international perspective. J Epidemiol Community Health. 2000;54:660–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Higashi H, Barendregt JJ, Vos T. The burden of congenital anomalies amenable to surgeries in low-income and middle-income countries: a modelled analysis. Lancet. 2013;381:S62.

    Article  Google Scholar 

  4. Christianson A, Howson CP, Modell B. March of dimes global report on birth defects. March of Dimes Birth Defects Foundation; 2006. http://www.marchofdimes.org/materials/global-report-on-birth-defects-the-hidden-toll-of-dying-and-disabled-children-full-report.pdf. Accessed 9 June 2015.

  5. Jha P. Reliable mortality data: a powerful tool for public health. Natl Med J India. 2001;14:129–31.

    CAS  PubMed  Google Scholar 

  6. Shamnas M, Arya P, Thottumkal VA, Deepak MG. Congenital anomalies: a major public health issue in India. Int J Pharm Chem Biol Sci. 2013;3(3):577–85.

    Google Scholar 

  7. Taksande A, Vilhekar K, Chaturvedi P, Jain M. Congenital malformations at birth in Central India: a rural medical college hospital based data. Indian J Hum Genet. 2010;16(3):159–63.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Agarwal SS, Singh U, Singh PS, Singh SS, Das V, Sharma A, et al. Prevalence and spectrum of congenital malformations in a prospective study at a teaching hospital. Indian J Med Res. 1991;94:413–9.

    CAS  PubMed  Google Scholar 

  9. Singh M. Hospital-based data on perinatal and neonatal mortality in India. Indian Pediatr. 1986;23(8):579–84.

    CAS  PubMed  Google Scholar 

  10. Sarkar S, Patra C, Dasgupta MK, Nayek K, Karmakar PR. Prevalence of congenital anomalies in neonates and associated risk factors in a tertiary care hospital in eastern India. J Clin Neonatol. 2013;2(3):131–4.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Sridhar K. A community-based survey of visible congenital anomalies in rural Tamil Nadu. Indian J Plast Surg. 2009;42(Suppl):S184–91.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Kumar V, Singh AJ, Marwaha RK. An epidemiological study of congenital malformations in rural children. Indian Pediatr. 1994;31(8):909–14.

    CAS  PubMed  Google Scholar 

  13. Shah K, Pens C. Study of incidence of congenital anomalies in new borns. Gujarat Med J. 2013;68(2):97–9.

    Google Scholar 

  14. Bhat BV, Babu L. Congenital malformations at birth: a prospective study from south India. Indian J Pediatr. 1998;65(6):873–81.

    Article  CAS  PubMed  Google Scholar 

  15. Grover N. Congenital malformations in Shimla. Indian J Pediatr. 2000;67(4):249–51.

    Article  CAS  PubMed  Google Scholar 

  16. Mahadevan B, Bhat BV. Neural tube defects in Pondicherry. Indian J Pediatr. 2005;72(7):557–9.

    Article  CAS  PubMed  Google Scholar 

  17. Cherian A, Seena S, Bullock RK, Antony AC. Incidence of neural tube defects in the least-developed area of India: a population-based study. Lancet. 2005;366(9489):930–1.

    Article  PubMed  Google Scholar 

  18. Godbole K, Deshmukh U, Yajnik C. Nutrigenetic determinants of neural tube defects in India. Indian Pediatr. 2009;46(6):467–75.

    PubMed  Google Scholar 

  19. Sharma R. Birth defects in India: hidden truth, need for urgent attention. Indian J Hum Genet. 2013;19(2):125–9.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Punjab: uranium deforms kids in Faridkot. Punjab Newsline Network. 2009. http://cndpindia.org/2009/04/punjab-uranium-deforms-kids-in-faridkot/. Accessed 9 June 2015.

  21. Yadav P. Farmers suffer toxic-induced dent. Times of India. 2007. http://timesofindia.indiatimes.com/city. Accessed 9 June 2015.

  22. Putra ki chah mein mor pankh kha rahin mahilayen. Dainik Bhaskar. 2007; 7(col7–8).

  23. Neogi S. Congenital malformations: unexplored causes. Indian Paediatr. 2007;44:941.

    Google Scholar 

  24. Bandyopadhyay S, Singh AJ. Sex selection through traditional drugs in rural north India. Indian J Community Med. 2007;32:32–4.

    Article  Google Scholar 

  25. Manchanda S, Saikia B, Gupta N, Chowdhary S, Puliyel J. Sex ratio at birth in India, its relation to birth order, sex of previous children and use of indigenous medicine. PLoS One. 2011;6(6):e20097.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Bhagat N, Laskar AR, Sharma N. Women’s perception about sex selection in an urban slum in Delhi. J Reprod Infant Psychol. 2012;. doi:10.1080/02646838.2011.635297.

    Google Scholar 

  27. Dewan P, Gupta P. Burden of congenital rubella syndrome (CRS) in India: a systematic review. Indian Pediatr. 2012;49(5):377–99.

    Article  PubMed  Google Scholar 

  28. Chandy S, Abraham AM, Jana AK, Agarwal I, Kekre A, Korula G, et al. Congenital rubella syndrome and rubella in Vellore, South India. Epidemiol Infect. 2010;139(6):962–6.

    Article  PubMed  Google Scholar 

  29. Panda C, Singh A. Risk factors of congenital malformations reporting at PGIMER, Chandigarh: a case-control study [MPH thesis]. Chandigarh: School of Public Health, Post Graduate Institute of Medical Education and Research. 2009.

  30. Census Info India. http://censusindia.gov.in/2011-common/censusdataonline.html. Accessed 9 June 2015.

  31. Rastriya Bal Suraksha Karyakram (RBSK)—child health screening and early intervention services under NHM. Available at: http://nrhm.gov.in/nrhm-components/rmnch-a/child…/guidelines.html. Accessed 13 Mar 2015.

  32. National Health Mission, Haryana. Available at: http://www.nrhmharyana.gov.in/. Accessed 1 May 2015.

  33. Chung W. Teratogens and their effects. Available at: http://www.columbia.edu/itc/hs/medical/humandev/2004/Chpt23-Teratogens.pdf. Accessed 13 Mar 2015.

  34. Chuang CH, Doyle P, Wang JD, Chang PJ, Lai JN, Chen PC. Herbal medicines used during the first trimester and major congenital malformations: an analysis of data from a pregnancy cohort study. Drug Saf. 2006;29(6):537–48.

    Article  PubMed  Google Scholar 

  35. Wang CC, Li L, Tang LY, Leung PC. Safety evaluation of commonly used Chinese herbal medicines during pregnancy in mice. Hum Reprod. 2012;27:2448–56.

    Article  PubMed  Google Scholar 

  36. Chuang CH, Lai JN, Wang JD, Chang PJ, Chen PC. Use of Coptidis Rhizoma and foetal growth: a follow-up study of 9,895 pregnancies. Pharmacoepidemiol Drug Saf. 2006;15(3):185–92.

    Article  PubMed  Google Scholar 

  37. Shih CC, Liao CC, Su YC, Tsai CC, Lin JG. Gender differences in traditional Chinese medicine use among adults in Taiwan. PLoS One. 2012;7(4):e32540.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Louik C, Gardiner P, Kelley K, Mitchell AA. Use of herbal treatments in pregnancy. Am J Obstet Gynecol. 2010;202:439.e1–10.

    Article  Google Scholar 

  39. Chen YC, Tsai CH, Lee Y. Gestational medication use, birth conditions, early postnatal exposures for childhood asthma. Clin Dev Immunol. 2012;2012:913426.

    PubMed Central  PubMed  Google Scholar 

  40. Rahman AA, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, Duad WNW. The use of herbal medicines during pregnancy and perinatal mortality in Tumpat district, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2007;38:1150–7.

    Google Scholar 

  41. Chan TY. The prevalence use and harmful potential of some Chinese herbal medicines in children and children. Vet Hum Toxicol. 1994;36(3):238–40.

    CAS  PubMed  Google Scholar 

  42. Gupta SK, Jani JP, Saiyed HN, Kashyap SK. Health hazards in pesticide formulators exposed to a combination of pesticides. Indian J Med Res. 1984;79:666–72.

    CAS  PubMed  Google Scholar 

  43. Saiyed HN, Sadhu HG, Bhatnagar VK, Dewan A, Venkaiah K, Kashyap SK. Cardiac toxicity following short-term exposure to methomyl in spraymen and rabbits. Hum Exp Toxicol. 1992;11(2):93–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The research team acknowledges the contribution of Dr. Amit Phogat, Dr. Rupinder Sahota and Dr. Deepika Gupta from the National Health Mission, Haryana, India, for the support they extended during the completion of the study. The team also appreciates the work of its research associates, Mr. Shamlal Sikri and Dr. Sapna Chopra from the Indian Institute of Public Health–Delhi, for their contribution towards data collection, and of Mr. Manoj Soni, Data Management and Support Unit, Indian Institute of Public Health–Delhi, for helping the team with database development and data management. The authors are grateful to Professor Pat Doyle, Department of Epidemiology, London School of Hygiene and Tropical Medicine, for her contribution in improving the manuscript.

Author information

Authors and Affiliations

  1. Indian Institute of Public Health–Delhi (IIPH–D), Public Health Foundation of India (PHFI), Plot number 47, Sector 44, Gurgaon, 122002, Haryana, India

    Sutapa Bandyopadhyay Neogi, Preeti H. Negandhi & Sanjay Zodpey

  2. Government of Haryana, Panchkula, Haryana, India

    Navraj Sandhu

  3. National Health Mission, Panchkula, Haryana, India

    Ravi Kant Gupta & Rakesh Gupta

  4. Thapar University, Patiala, India

    Abhijit Ganguli

  5. Department of Community Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Amarjeet Singh

  6. Rashtriya Bal Suraksha Karyakram, Government of India, New Delhi, India

    Arun Singh

Authors
  1. Sutapa Bandyopadhyay Neogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Preeti H. Negandhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Navraj Sandhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ravi Kant Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abhijit Ganguli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sanjay Zodpey
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Amarjeet Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Arun Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rakesh Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sutapa Bandyopadhyay Neogi.

Ethics declarations

Funding

The National Health Mission, Government of Haryana, India, provided financial assistance to conduct the study described in this article.

Conflicts of interest

Sutapa Bandyopadhyay Neogi, Preeti H. Negandhi, Navraj Sandhu, Ravi Kant Gupta, Abhijit Ganguli, Sanjay Zodpey, Amarjeet Singh, Arun Singh and Rakesh Gupta have no conflicts of interest that are directly relevant to the content of this study.

Ethical approval

Permission was sought from the state and district authorities before initiating the study. Approval was obtained from Institutional Ethics Committees of the Indian Institute of Public Health–Delhi, Public Health Foundation of India.

Patient consent

The project team provided potentially eligible parents with detailed information about the study, in the local language. Written consent was provided by every mother who voluntarily agreed to participate in the study. Confidentiality of the information collected was maintained at every level.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 739 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neogi, S.B., Negandhi, P.H., Sandhu, N. et al. Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India. Drug Saf 38, 789–797 (2015). https://doi.org/10.1007/s40264-015-0309-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40264-015-0309-5

Keywords

Search

Navigation