Skip to main content
SpringerLink
Log in

Maternal Use of Antiviral Drugs, Immune Globulins, or Vaccines and Infant Congenital Malformations

  • Chapter
  • First Online:
Maternal Drug Use and Infant Congenital Malformations

  • 393 Accesses

Abstract

There are very few signs of teratogenicity of antiviral drugs but further data are needed on specific drugs, notably on antiretroviral drugs. An observed association between use of zidovudine and infant hypospadias needs verification. Dolutegravir should if possible be avoided until the suspected association with neural tube defects has been clarified. Immune globulins can be used without risk during pregnancy. Vaccinations—notably based on living virus—should, if possible, be avoided during the first trimester but if inadvertent use occurs the risk of malformations is low.

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

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Avalos LA, Chen H, Yang C, Andrade SE, Cooper WO, Cheetham CT, Davis RL, Dublin S, Hammad TA, Kaplan S, Pawloski PA, Raebel MA, Scott PE, Smith DH, Toh S, Li D-K. The prevalence and trends of antiviral medication use during pregnancy in the U.S.A. A population-based study of 664,297 deliveries in 2001-2007. Matern Child Health J. 2014;18:64–72. https://doi.org/10.1007/s10995-013-1234-9.

    Article  PubMed  Google Scholar 

  • Badell ML, Meaney-Delman D, Methodius G, Tuuli G, Rasmussen SA, Petersen BW, Sheffield JS, Belgi RH, Damon IK, Jamieson DJ. Risks associated with smallpox vaccination in pregnancy: a systematic review and meta-analysis. Obstet Gynecol. 2015;125:1439–51.

    Article  Google Scholar 

  • Badilla X, Morice A, Avila-Aquero ML, Saenz E, Cerda I, Reef S, Castillo-Solórzano C. Fetal risk associated with rubella vaccination during pregnancy. Pediatr Infect Dis J. 2007;26:830–5.

    Article  Google Scholar 

  • Bar-Oz B, Levichek Z, Moretti ME, Mah C, Andreou S, Koren G. Pregnancy outcome following rubella vaccination: a prospective controlled study. Am J Med Genet A. 2004;130A:52–4.

    Article  Google Scholar 

  • Bérard A, Sheehy O, Zhao JP, Abrahamowicz M, Loutfy M, Boucoiran I, Bernatsky S. Antiretroviral combination use during pregnancy and the risk of major congenital malforomations. AIDS. 2017;31:2267–77.

    Article  Google Scholar 

  • Castillo-Solórzano C, Reef SE, Morice A, Vascones N, Chevez AE, Castalia-Soares R, Torres C, Vizzotti C, Ruiz Matus C. Rubella vaccination of unknowingly pregnant women during mass campaigns for rubella and rubella syndrome elimination, the 2001-2008. J Infect Dis. 2011;204(Suppl):713–7.

    Article  Google Scholar 

  • Chambers, Johnson D, Xu R, Luo C, Mitchell AA, Schatz M, Jones KL, OTIS Collaborative Research Group. Risks and safety of pandemic H1N1 influenza vaccine in pregnancy: birth defects, spontaneous abortion, preterm delivery and small for gestational age infants. Vaccine. 2013;31:6026–32.

    Article  Google Scholar 

  • Conlin AMS, Sevick CJ, Gumbs GR, Khodr ZG, Bukowinski AT. Safety of inadvertent anthrax vaccination during pregnancy: an analysis of birth defects in the U.S. military population, 2003-2010. Vaccine. 2017;35:4414–20.

    Article  Google Scholar 

  • Czeizel AE, Rockenbauer M. Tetanus toxoid and congenital abnormalities. Int J Gynecol Obstet. 1999;199(64):253–8.

    Article  Google Scholar 

  • Dana A, Buchanan KM, Goss MA, Seminack MM, Shields KE, Koen S, Cunnninghman ML, Haupt RM. Pregnancy outcome from the pregnancy registry of a human papillomavirus type 6/11/16/18 vaccine. Obstet Gynecol. 2009;114:1170–8.

    Article  Google Scholar 

  • Ergenoğlu AM, Yeniel AO, Yildirim N, Kazandi M, Akercan F, Sağoi S. Rubella vaccination during the preconception period or in pregnancy and perinatal and fetal outcome. Turk J Pediatr. 2012;54:230–3.

    PubMed  Google Scholar 

  • Fabiani M, Bella A, Rota MC, Clagan E, Gallo T, D’Amato M, Pezzotti P, Ferrara L, Demicheli V, Martinelli D, Prato R, Rizzo C. A/H1N1 pandemic influenza vaccination: a retrospective evaluation of adverse maternal, fetal and neonatal outcomes in a cohort of pregnant women in Italy. Vaccine. 2015;33(19):2240–7.

    Article  Google Scholar 

  • Goss MA, Lievano F, Buchanan KM, Seminack MM, Cunningham ML, Dana A. Final report on exposure during pregnancy from a pregnancy registry for quadrivalent human papilloma vaccine. Vaccine. 2015;26:3422–8.

    Article  Google Scholar 

  • Graner S, Svensson T, Beau A-B, Damase-Michel C, Engeland A, Furu K, Hviid A, Eldevik Håberg S, Mølgaard-Nielsen D, Pasternak B, Kieler H. Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations: population based European register study. BMJ. 2017;356:j629. https://doi.org/10.1136/bmj.j629.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grout L, Martinez-Pino I, Ciglenecki I, Kelta S, Diallo AA, Traore B, Delamou D, Toure O, Nicholas S, Rusch B, Straderini N, Serafini M, Grais RF, Luquero FJ. Pregnancy outcomes after a mass vaccination campaign with an oral cholera vaccine in Guinea: a retrospective cohort study. PLoS Negl Trop Dis. 2015;9:e0004274. https://doi.org/10.1371/journal.pntd.0004274.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harjulehto-Mervaala T, Aro T, Hillesmaa VK, Saxén H, Hovi T, Saxén L. Oral polio vaccination during pregnancy: no increase in the occurrence of congenital malformations. Am J Epidemiol. 1993;138:407–14.

    Article  CAS  Google Scholar 

  • Källén B, Olausson PO. Vaccination against H1N1 influenza with Pandemrix® during pregnancy and delivery outcome: a Swedish register study. BJOG. 2012;119:1583–90.

    Article  Google Scholar 

  • Kumar RM, Hughes PF, Khuranna A. Zidovudine use in pregnancy: a report on 104 cases and the occurrence of birth defects. J Acquir Immune Defic Syndr. 1994;7:1034–9.

    CAS  PubMed  Google Scholar 

  • Lipkind HS, Vazquez-Benitez G, Nordin JD, Romitti PA, Naleway AL, Klein NP, Hechter RC, Jackson ML, Hambidge SJ, Lee GM, Sukumaran L, Kharbanda EO. Maternal and infant outcomes after human papillomavirus vaccination in the perticonceptional period or during pregnancy. Obstet Gynecol. 2017;130:599–608.

    Article  Google Scholar 

  • Liu M, Cai H, Yi W. Safety of telbivudine treatment for chronic hepatitis B for the entire pregnancy. J Viral Hepat. 2013;20(Suppl 1):65–70. https://doi.org/10.1111/jvh.12066.

    Article  PubMed  Google Scholar 

  • Minakami H, Kubo T, Nakai A, Saito S, Unno N. Pregnancy outcomes of women exposed to laninamivir during pregnancy. Pharmacoepidemiol Drug Saf. 2014;23:1084–7.

    Article  CAS  Google Scholar 

  • Minussi L, Mohrdiech R, Bercini M, Sanseverino MT, Momino W, Callegari-Jaques SM, Schuler-Faccini L. Prospective evaluation of pregnant women vaccinated against rubella in southern Brazil. Reprod Toxicol. 2008;25:120–3.

    Article  CAS  Google Scholar 

  • Namael MH, Ziaee M, Naseh N. Congenital rubella syndrome in infants of women vaccinated during or just before pregnancy with measles-rubella vaccine. Indian J Med Res. 2008;127:551–4.

    Google Scholar 

  • Nasiri R, Yoseffi J, Khajedaloe M, Sarafraz Yazdi M, Delgoshaei F. Congenital rubella syndrome after rubella vaccination in 1-4 weeks periconceptional period. Indian J Pediatr. 2009;76:279–82.

    Article  CAS  Google Scholar 

  • Newschaffer CJ, Cocroft J, Anderson CE, Hauck WW, Turner BJ. Prenatal zidovudine use and congenital anomalies in a Medicaid population. J Acquir Immune Defic Syndr. 2000;24:249–56.

    Article  CAS  Google Scholar 

  • Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA. 2010;304:859–66.

    Article  CAS  Google Scholar 

  • Pasternak B, Svanström H, Mølgaard-Nielsen D, Krause TG, Emborg HD, Melbye M, Hviid A. Risk of adverse fetal outcomes following administration of a pandemic influenza A(H1N1) vaccine during pregnancy. JAMA. 2012;308:165–74.

    Article  CAS  Google Scholar 

  • Phiri K, Hernandez-Diaz S, Dugan KB, Williams PL, Dudley JA, Jules A, Callahan ST, Seage GR 3rd, Cooper WO. First trimester exposure to antiretroviral therapy and risk of birth defccts. Pediatr Infect Dis J. 2014;33:741–6.

    Article  Google Scholar 

  • Pierce M, Kuribczuk JJ, Spark P, Brocklehurst P, Knight M, ön behalf of UKOSS. Perinatal outcome after maternal 2009/H1N1 infection: national cohort study. BMJ. 2011;342:d3214. https://doi.org/10.1136/bmj.d3214.

    Article  PubMed  PubMed Central  Google Scholar 

  • Preblud SR, Stetler HC, Frank JA Jr, Greaves WL, Hinman AR, Herrmann KL. Fetal risk associated with rubella vaccine. JAMA. 1981;246:1413–7.

    Article  CAS  Google Scholar 

  • Ratanajamit C, Vinther Skriver M, Jepsen P, Chongsuviva V, Olsen J, Sørensen HT. Adverse pregnancy outcome in women exposed to acyclovir during pregnancy: a population-based observational study. Scand J Infect Dis. 2003;35:255–9.

    Article  CAS  Google Scholar 

  • Ryan MA, Gumbs GR, Conlin AM, Sevick CJ, Jacobson IG, Snell KJ, Spooner CN, Smith TC. Evaluation of preterm births and birth defects in liveborn infants of US military women who received smallpox vaccine. Birth Defects Res A Clin Mol Teratol. 2008a;82:533–9.

    Article  CAS  Google Scholar 

  • Ryan MA, Smith TC, Sevick CJ, Honner WK, Loach RA, Moore CA, Erickson JD. Birth defects among infants born to women who received anthrax vaccine in pregnancy. Am J Epidemiol. 2008b;168:434–42.

    Article  Google Scholar 

  • Scheller NM, Pasternak B, Mølgaard-Nielsen S, Svanström H, Hviid A. Quadrivalent HPV vaccination and the risk of adverse pregnancy outcome. N Engl J Med. 2017;376:1223–33.

    Article  Google Scholar 

  • Stone KM, Reiff-Eldridge R, White AD, Cordero JF, Brown Z, Alexander ER, Andrews EB. Pregnancy outcomes following systemic prenatal acyclovir exposure: conclusions from the International Acyclovir Pregnancy Registry, 1984-1999. Birth Defects Res A Clin Mol Teratol. 2004;70:201–7.

    Article  CAS  Google Scholar 

  • Suzano CES, Amaral E, Sato HK, Papaiordanou PM. The effects of yellow fever immunization (17DD) inadvertently used in early pregnancy during a mass campaign in Brazil. Vaccine. 2006;24:1421–6.

    Article  CAS  Google Scholar 

  • Svensson T, Granath F, Stephanson O, Kieler H. Birth outcomes among women exposed to neuraminidase inhibitors during pregnancy. Pharmacoepidemiol Drug Saf. 2011;20:1030–4.

    Article  CAS  Google Scholar 

  • Trotta F, Da Cas R, Alegiani SS, Gramegna M, Venegoni M, Zocchetti C, Traversa G. Evaluation of the safety of A/H1N1 pandemic vaccination during pregnancy: cohort study. BMJ. 2014;348:g3361. https://doi.org/10.1136/bmj.g3361.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Watts DH, Covington DL, Beckerman K, Garcia P, Scheuerle A, Dominguez K, Ross B, Sarks S, Chavers S, Tilson H. Assessing the risk of birth defects associated with antiretroviral exposure during pregnancy. Am J Obstet Gynecol. 2004;191:985–92.

    Article  CAS  Google Scholar 

  • Watts DH, Li D, Handelsman E, Tilson H, Paul M, Foca M, Vajaranant M, Diaz C, Tuomala R, Thompson B. Assessment of birth defects according to maternal therapy among infants in the Women and Infants Transmission Study. J Acquir Immune Defic Syndr. 2007;44:299–305.

    Article  Google Scholar 

  • White A, Eldridge R, Andrews E. Birth outcomes following zidovudine exposure in pregnant women; the Antiretroviral Pregnancy Registry. Acta Paediatr Suppl. 1997;421:86–8.

    Article  CAS  Google Scholar 

  • Wilson E, Goss MA, Marin M, Shields KE, Seward JE, Rasmussen SA, Sharrar RG. Varicella vaccine exposure during pregnancy: data from 10 years of the pregnancy register. J Infect Dis. 2008;197(Suppl 2):178–84.

    Article  Google Scholar 

  • Yi W, Li M, Cal H-D. Safety of lamivudine treatment for chronic hepatitis B in early pregnancy. World J Gastroenterol. 2012;18:6645–50.

    Article  CAS  Google Scholar 

  • Zach R, Makhenon J, Shapiro RL. Neural-tube defects with dolutegravir treatment from the time of conception. N Engl J Med. 2018;379:979–81.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tornblad Institute for Comparative Embryology, Lund University, Lund, Sweden

    Bengt Källén

Authors
  1. Bengt Källén
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Källén, B. (2019). Maternal Use of Antiviral Drugs, Immune Globulins, or Vaccines and Infant Congenital Malformations. In: Maternal Drug Use and Infant Congenital Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-17898-7_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-17898-7_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17897-0

  • Online ISBN: 978-3-030-17898-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation