Publications by authors named "Alissa Van Zutphen"
Background: Fungal infections are common among pregnant people. Recent studies suggest positive associations between oral antifungals used to treat fungal infections and congenital heart defects (CHDs).
Methods: We estimated associations between first trimester antifungal use and 20 major, specific CHDs using data from the National Birth Defects Prevention Study (NBDPS), a multi-site, case-control study that included pregnancies with estimated delivery dates from October 1997 through December 2011.
Purpose: Recent studies suggest increased birth defect risk associated with maternal use of specific oral antifungals. We estimated associations between first-trimester antifungal use and selected non-cardiac birth defects using National Birth Defects Prevention Study (NBDPS) data.
Methods: Participants with a pregnancy affected by a study-eligible birth defect ("cases") were ascertained from 10 birth defect surveillance programs; participants who delivered livebirths without a major birth defect ("controls") were randomly selected from birth records or hospital discharge lists.
Article Synopsis
- Zolpidem, a medication for insomnia, crosses the placenta, but its safety during pregnancy is largely unknown.
- The study analyzed the impact of zolpidem use before and during early pregnancy on birth defects through data from two comprehensive studies involving over 62,000 cases.
- Findings showed rare use of zolpidem and provided inconclusive evidence regarding significant risk increases for birth defects, with some estimates suggesting potential but small increases for a few specific defects.
Article Synopsis
- Heparin and low-molecular-weight heparin are safe anticoagulants during pregnancy because they don’t cross the placenta, but previous studies have not closely examined their associations with specific birth defects.
- Analyzing data from a significant study, researchers found that out of 42,743 women, a small percentage used heparin in early pregnancy, with odds ratios (ORs) indicating potential risks for certain birth defects like limb deficiencies and heart defects.
- While some associations were elevated, the rarity of heparin use limited the analysis, suggesting that more research is needed to understand the relationship between heparin and specific birth defects, while also considering that underlying risks exist regardless of medication use.
Background We sought to characterize health care usage for adolescents with congenital heart defects (CHDs) using population-based multisite surveillance data. Methods and Results Adolescents aged 11 to 18 years with ≥1 CHD-related diagnosis code and residing in 5 US sites were identified in clinical and administrative data sources for the years 2011 to 2013. Sites linked data on all inpatient, emergency department (ED), and outpatient visits.
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- Previous studies indicate a connection between pregestational diabetes and birth defects, so the current research examines the effects of type 1 (PGD1) versus type 2 (PGD2) diabetes on birth defects using National Birth Defects Prevention Study data.
- The study analyzed data from over 29,000 cases of birth defects and found that mothers with PGD1 and PGD2 had higher adjusted odds ratios for various defects, with the most significant risk linked to sacral agenesis.
- The findings suggest that both types of diabetes are associated with a variety of birth defects across multiple body systems, highlighting the need for future research on glycemic control to better understand and prevent these risks.
Background: Both short and long interpregnancy intervals (IPIs) have been associated with adverse birth outcomes. We undertook a multistate study to describe the prevalence of selected birth defects by IPI.
Methods: We obtained data from nine population-based state birth defects registries for singleton live births in 2000-2009 among mothers with a previous live birth identified through birth certificates.
Article Synopsis
- Hydroxychloroquine, commonly used for rheumatic diseases and considered safe in pregnancy, is being studied as a treatment for COVID-19, but data on its birth defect risks is limited.
- A study analyzed the health and medication reports of pregnant women who used hydroxychloroquine and their children's birth outcomes, revealing a very small percentage of reported birth defects among these women.
- The findings did not show a clear pattern of birth defects linked to hydroxychloroquine, indicating no significant evidence of increased risk; however, due to the small number of cases, results should be interpreted with caution.
Background: Individuals with congenital heart defects (CHDs) are recommended to receive all inpatient cardiac and noncardiac care at facilities that can offer specialized care. We describe geographic accessibility to such centers in New York State and determine several factors associated with receiving care there.
Methods: We used inpatient hospitalization data from the Statewide Planning and Research Cooperative System (SPARCS) in New York State 2008-2013.
Objectives: Most individuals born with congenital heart defects (CHDs) survive to adulthood, but healthcare utilization patterns for adolescents and adults with CHDs have not been well described. We sought to characterize the healthcare utilization patterns and associated costs for adolescents and young adults with CHDs.
Methods: We examined 2009-2013 New York State inpatient admissions of individuals ages 11-30 years with ≥1 CHD diagnosis codes recorded during any admission.
Background: Evidence regarding associations between maternal asthma medication use and birth defects is mixed.
Objective: Estimate associations between asthma medciation use and 52 birth defects using National Birth Defects Prevention Study data from 1997 to 2011.
Methods: We compared self-reported maternal asthma medication use for 28,481 birth defect cases and 10,894 nonmalformed controls.
Background: Maternal hypertension has been associated with congenital heart defect occurrence in several studies. We assessed whether maternal genotypes associated with this condition were also associated with congenital heart defect occurrence.
Methods: We used data from the National Birth Defects Prevention Study to identify non-Hispanic white (NHW) and Hispanic women with (cases) and without (controls) a pregnancy in which a select simple, isolated heart defect was present between 1999 and 2011.
Background: In the United States, >1 million adults are living with congenital heart defects (CHDs), but gaps exist in understanding the health care needs of this growing population.
Objectives: This study assessed the demographics, comorbidities, and health care use of adults ages 20 to 64 years with CHDs.
Methods: Adults with International Classification of Disease-9th Revision-Clinical Modification CHD-coded health care encounters between January 1, 2008 (January 1, 2009 for Massachusetts) and December 31, 2010 were identified from multiple data sources at 3 U.
With increasing survival trends for children and adolescents with congenital heart defects (CHD), there is a growing need to focus on transition from pediatric to adult specialty cardiac care. To better understand parental perspectives on the transition process, a survey was distributed to 451 parents of adolescents with CHD who had recent contact with the healthcare system in Georgia (GA) and New York (NY). Among respondents, 90.
View Article and Find Full Text PDFBackground: Women with congenital heart defects (CHDs) experiencing pregnancies require specialized delivery care and extensive monitoring that may not be available at all birthing hospitals. In this study, we examined proximity to, and delivery at, a hospital with an appropriate level of perinatal care for pregnant women with CHDs and evaluated predictors of high travel distance to appropriate care. Appropriate care was defined as Level 3 perinatal hospitals and Regional Perinatal Centers (RPCs).
View Article and Find Full Text PDFImproved treatment of congenital heart defects (CHDs) has resulted in women with CHDs living to childbearing age. However, no US population-based systems exist to estimate pregnancy frequency or complications among women with CHDs. Cases were identified in multiple data sources from 3 surveillance sites: Emory University (EU) whose catchment area included 5 metropolitan Atlanta counties; Massachusetts Department of Public Health (MA) whose catchment area was statewide; and New York State Department of Health (NY) whose catchment area included 11 counties.
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- The study investigates the risk of birth defects linked to maternal anesthesia exposure during pregnancy, using data from the National Birth Defects Prevention Study.
- It employs logistic regression to analyze associations between types of anesthesia and specific birth defects, adjusting for various maternal factors.
- The results indicate no significant links between periconceptional anesthesia exposure and birth defects, with most odds ratios being close to null.
Background: Pregnant women with congenital heart defects (CHDs) may be at increased risk for adverse events during delivery.
Objectives: This study sought to compare comorbidities and adverse cardiovascular, obstetric, and fetal events during delivery between pregnant women with and without CHDs in the United States.
Methods: Comorbidities and adverse delivery events in women with and without CHDs were compared in 22,881,691 deliveries identified in the 2008 to 2013 National Inpatient Sample using multivariable logistic regression.
The prevalence, co-morbidities, and healthcare utilization in adolescents with congenital heart defects (CHDs) is not well understood. Adolescents (11 to 19 years old) with a healthcare encounter between January 1, 2008 (January 1, 2009 for MA) and December 31, 2010 with a CHD diagnosis code were identified from multiple administrative data sources compiled at 3 US sites: Emory University, Atlanta, Georgia (EU); Massachusetts Department of Public Health (MA); and New York State Department of Health (NY). The estimated prevalence for any CHD was 4.
View Article and Find Full Text PDFBackground: Improved treatment of congenital heart defects (CHDs) has increased survival of persons with CHDs; however, no U.S. population-based systems exist to assess prevalence, healthcare utilization, or longer-term outcomes among adolescents and adults with CHDs.
View Article and Find Full Text PDFBackground: There are limited data on the relationship between antihypertensive medication use in early pregnancy and risk of birth defects.
Methods: Using data from the National Birth Defects Prevention Study, we examined associations between specific antihypertensive medication classes and 28 noncardiac birth defects. We analyzed self-reported data on 17,038 case and 11,477 control pregnancies with estimated delivery dates during 1997-2011.
Introduction: We examined the association of biliary atresia with maternal dietary intake, using National Birth Defects Prevention Study (NBDPS) data from 152 cases and 11,112 nonmalformed controls born 1997-2011.
Methods: NBDPS is a multisite, population-based case-control study. Exposure data were from maternal telephone interviews, which included a food frequency questionnaire.
Background: Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs.
Methods: Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs.
Background Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension. Methods We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study.
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