European Journal of Epidemiology

, Volume 21, Issue 1, pp 65–75 | Cite as

Population-based Case–Control Study of the Common Cold During Pregnancy and Congenital Abnormalities

  • Nándor ÁcsEmail author
  • Ferenc Bánhidy
  • Erzsébet Horváth-Puhó
  • Andrew E. Czeizel


The common cold is the most frequent maternal disease during pregnancy. The possible association between different congenital abnormalities and the common cold in pregnant women was evaluated in the data set of the Hungarian Case–Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of 22,843 cases with congenital abnormalities, 3,827 (16.8%) had mothers with the common cold, while of 38,151 population controls without congenital abnormalities, 5,475 (14.4%) (adjusted prevalence odds ratio: POR: 1.26 with 95% CI: 1.20–1.32). Of 834 malformed controls with Down syndrome, 114 (17.3%) had mothers with the common cold (POR: 0.96 with 95% CI: 0.80–1.16). Nearly half of mothers with the common cold had secondary complications with antifever therapy. The comparison of cases with 25 congenital abnormalities and population control mothers with medically recorded common cold during the second and third months of gestation showed that five congenital abnormality groups: congenital hydrocephaly (3.6, 1.3–9.7), cleft lip±palate (2.3, 1.5–3.6), posterior cleft palate (2.3, 1.2–4.1), limb deficiencies (2.2, 1.1–4.1) and multiple CAs (2.0, 1.4–2.9) had adjusted POR 2 or more. The comparison of cases with different congenital abnormalities and malformed controls (including offspring with Down syndrome) as referent, indicated a higher prevalence of the common cold during the second and third month of gestation only in the mothers of cases with cleft lip±palate (adjusted POR: 1.7 with 95% CI: 1.2–2.5), however, congenital hydrocephaly, neural-tube defects and multiple CAs had also mothers with a somewhat higher occurrence of the common cold. The possible association between the common cold during early pregnancy and the above mentioned congenital abnormalities may be connected mainly with the indirect effect of secondary complications of maternal common cold, particularly high fever because antifever drugs were able to prevent the possible teratogenic effect of the common cold.


Antifever therapy Case–control study Common cold Congenital abnormalities Pregnancy 



congenital abnormality


confidence interval


Hungarian Congenital Abnormality Registry


Hungarian Case–Control Surveillance of Congenital Abnormalities


prevalence odds ratio


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Mäkele, MJ, Puhakka, T, Ruuskanen, O,  et al. 1998Viruses and bacteria in the etiology of common coldJ Clin Microbiol36539542Google Scholar
  2. 2.
    Heikkinen, T, Järvinen, A 2003The common coldLancet3615159PubMedGoogle Scholar
  3. 3.
    Adams, PF, Hendershot, GE, Marano, MA 1999Current estimates from the National Health Interview SurveyVital Health Stat101996Google Scholar
  4. 4.
    Kurppa, K, Holmberg, PC, Kuosma, E,  et al. 1991Anencephaly and maternal common coldTeratology445155CrossRefPubMedGoogle Scholar
  5. 5.
    Zhang, J, Cai, WW 1993Association of the common cold in the first trimester of pregnancy with birth defectsPediatrics92559563PubMedGoogle Scholar
  6. 6.
    Czeizel, AE, Rockenbauer, M, Siffel, C, Varga, E 2001Description and mission evaluation of the Hungarian Case–Control Surveillance of Congenital Abnormalities, 1980–1996Teratology63176185CrossRefPubMedGoogle Scholar
  7. 7.
    Czeizel, AE 1997First 25 years of the Hungarian Congenital Abnormality RegistryTeratology55299305CrossRefPubMedGoogle Scholar
  8. 8.
    Czeizel, AE, Petik, D, Vargha, P 2003Validation studies of drug exposures in pregnant womenPharmacoepid Drug Saf12409416Google Scholar
  9. 9.
    International Classification of Diseases. Volume I. World Health Organization, Geneva, 1977Google Scholar
  10. 10.
    Rockenbauer, M, Olsen, J, Czeizel, AE, Pedersen, L, Sorensen, HT 2001Recall bias in a case–control surveillance system on the use of medicine during pregnancyEpidemiology12461466CrossRefPubMedGoogle Scholar
  11. 11.
    Roulston, A, Marcellus, RC, Branton, PE 1999Viruses and apoptosisAnn Rev Microbiol53577628Google Scholar
  12. 12.
    Chambers, CD, Johnson, KA, Dick, LM,  et al. 1998Maternal fever and birth outcome: a prospective studyTeratology58251257CrossRefPubMedGoogle Scholar
  13. 13.
    Graham, J,Jr., Edwards, MJ 1998Teratogen update: gestational effects of maternal hyperthermia due to febrile illnesses and resultant patterns of defects in humanTeratology58209221CrossRefPubMedGoogle Scholar
  14. 14.
    Heinonen, OP, Slope, D, Shapiro, S 1977Birth Defects and Drugs in PregnancyPublishing Sciences GroupLittleton, MAGoogle Scholar
  15. 15.
    Bánhidy, F, Lowry, RB, Czeizel, AE 2005Risk and benefit of drug use during pregnancyInt J Med Sci2100106PubMedGoogle Scholar
  16. 16.
    Huang, RF, Ho, YH, Lin, HL,  et al. 1999Folate deficiency induce a cell cycle-specific apoptosis in Hep62 cellsJ Nutr1292531PubMedGoogle Scholar
  17. 17.
    Ács N, Bánhidy F, Puhó E, Czeizel AE, Maternal influenza during pregnancy and risk of congenital abnormalities in the offspring. Birth Defects Res (Part A) 2005; 73 (in press)Google Scholar
  18. 18.
    Milunsky, A, Ulcickas, M, Rothman, KJ,  et al. 1992Maternal heat exposure and neural-tube defectsJ Am Med Ass268882885CrossRefGoogle Scholar
  19. 19.
    Shaw, GM, Todoroff, K, Velie, EM, Lammer, EJ 1998Maternal illness, including fever, and medication use as risk factors of neural-tube defectsTeratology5717CrossRefPubMedGoogle Scholar
  20. 20.
    Medveczky, E, Puhó, E, Czeizel, AE 2004The evaluation of maternal illnesses in the origin of neural-tube defectsArch Obstet Gynec207244251Google Scholar
  21. 21.
    Lynberg, MC, Khoury, MJ, Lu, X, Cocian, T 1994Maternal flu, fever and the risk of neural-tube defects: a population-based case–control studyAm J Epidemiol140244255PubMedGoogle Scholar
  22. 22.
    Métneki, J, Puhó, E, Czeizel, AE 2005Maternal diseases and isolated orofacial clefts in HungaryBirth Defects Res (Part A)73617623Google Scholar
  23. 23.
    Botto, LD, Erickson, JD, Mulinare, J,  et al. 2002Maternal fever, multivitamin use and selected birth defects: evidence or interactionEpidemiology13620621CrossRefGoogle Scholar
  24. 24.
    Suarez, L, Felkner, M, Hendrics, K 2004The effect of fever, febrile illnesses, and heat exposures on the risk of neural-tube defects in a Texas–Mexico border populationBirth Defects Res (Part A)70815819Google Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Nándor Ács
    • 1
    Email author
  • Ferenc Bánhidy
    • 1
  • Erzsébet Horváth-Puhó
    • 2
    • 3
  • Andrew E. Czeizel
    • 2
  1. 1.Second Department of Obstetrics and Gynecology, School of MedicineSemmelweis UniversityBudapestHungary
  2. 2.Foundation for the Community Control of Hereditary DiseasesBudapestHungary
  3. 3.Department of Human Genetics and TeratologyNational Center for EpidemiologyBudapestHungary

Personalised recommendations