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Objective To investigate the association of pre-eclampsia (PE) or PE with superimposed chronic hypertension (PE + SCH) in pregnant women with the risk of various structural birth defects (i.e. congenital abnormalities) in their offspring. Study design A population-based case–control study using the Hungarian Case–Control Surveillance of Congenital Abnormalities data set (1980–1996), including 22,843 cases with congenital abnormalities and 38,151 matched controls without any congenital abnormalities. The incidence of PE and PE + SCH was compared in women who had offspring with congenital abnormalities (cases) and women who had offspring without any congenital abnormalities (controls). Results The incidence of PE was examined in 585 cases and 1017 controls, and the incidence of PE + SCH was examined in 154 cases and 269 controls. None of the 25 studied types of congenital abnormality was found to be more likely among the offspring of women with PE. However, the risks of renal dysgenesis [odds ratio (OR) 4.7, 95% confidence interval (CI) 1.7–12.8], esophageal atresia/stenosis (OR 4.6, 95% CI 1.8–12.2) and rectal/anal stenosis (OR 3.7, 95% CI 1.6–8.5) were higher in the offspring of pregnant women with PE + SCH. Conclusions PE in pregnant women was not associated with a higher risk of any congenital abnormalities in their offspring, but PE + SCH was associated with a higher risk of renal dysgenesis, esophageal atresia/stenosis and rectal/anal stenosis. These findings need confirmation in other studies.

Background The possible association between otitis media in pregnancy (OMP) and structural birth defects, that is, congenital abnormalities (CAs), in their offspring has not been studied. Methods The data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980 and 1996, was evaluated. Results There were 58 (0.25%) and 55 (0.14%) of 22 843 cases and 38 151 controls with mothers who had OMP, respectively. There was association of OMP and a higher risk of ear CA. Conclusions A possible explanation for the association of OMP with higher risk of ear CA may be some morphological deviation of the inner ear.

The administration of folic acid (FA) or multivitamin (MV) supplements during preconception to prevent neural tube defects is well established. Most pregnant women in Hungary use high doses of FA early in pregnancy, but it is unclear whether continuing these supplements after the first trimester reduces the rate of preterm delivery and low birth weight. The results of 2 meta-analyses on supplementation were inconclusive as to the benefits of continuation and recommended further investigation. Some practitioners have suggested that increased birth weight resulting from supplementation may increase the risk of complications. To address this issue, this study compared the effects of administering vitamin supplements in the second and the third trimester on length of gestation and fetal growth. Birth outcomes were determined using a population-based dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. The participants included 3 groups of women who ingested daily supplements containing (1) FA alone (n = 6293), (2) FA plus MV (n = 311), or (3) MV without FA (n = 169). The controls were a reference group comprising 7319 pregnant women who did not take the supplements. There was special emphasis on the third trimester, during which the most intensive fetal growth occurs. Compared to the reference sample, the mean gestational age at delivery in the FA alone group was 0.3 week longer (39.5 vs. 39.2) and the mean birth weight 37 g higher (3253 vs. 3216 g). The continuation of FA was associated with a significant reduction (7.6%) in the rate of preterm births compared with the reference sample (11.8%), but there was no similar reduction in the rate of low birth weight newborns. In the third trimester, the use of FA was associated with a 0.6 week prolongation of gestation (FA alone: 39.8 vs. reference sample: 39.2 weeks) and a lower rate of preterm birth (4.8%). These findings show that high dose FA supplementation during pregnancy, especially during the third trimester, are associated with a decreased risk of preterm birth.

Objective To estimate the risk of congenital abnormalities in the offspring of pregnant women with symptomatic cholelithiasis and complicated cholecystitis. Study design Comparison of the occurrence of medically recorded symptomatic cholelithiasis and complicated cholecystitis occurred any time of pregnancy (particularly in the second and/or third gestational month) of pregnant women who had malformed foetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities. Results Of 22,843 cases with CA, 62 (0.27%) had mothers with symptomatic cholelithiasis, while 119 (0.31%) mothers of 38,151 controls were recorded with symptomatic cholelithiasis. In addition, the mothers of 109 cases (0.48%) were affected by complicated cholecystitis during pregnancy compared with 145 controls (0.38%). Regarding the frequency, these two biliary diseases did not show any significant differences in the maternal variables, therefore case mothers were combined. The analysis of specific groups of congenital abnormalities showed an association between symptomatic cholelithiasis-complicated cholecystitis in the second and/or third gestation months, and neural tube defects (adjusted OR with 95% CI: 4.1, 1.3–13.4). Conclusion A higher rate of neural tube defects was found in the offspring of mothers with severe diseases of the biliary system during pregnancy. This finding needs to be confirmed by further studies and/or explanations to determine whether it is causal or a chance event.

Background The objective of the study was to evaluate the possible association between panic disorders during pregnancy and pregnancy complications, as well as birth outcomes: gestational age and birth weight, as well as preterm birth/low birthweight in newborns. Methodology Comparison of newborn infants (without any defects) born to mothers with or without panic disorder in the population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities. Main outcome measures were medically recorded pregnancy complications, as well as gestational age and birth weight, proportion of preterm birth and low birthweight. Principal findings Of 38,151 controls, 187 (0.5%) had mothers with panic disorders during pregnancy. Among pregnancy complications, anemia and polyhydramnion showed a higher prevalence in women with panic disorder. There was a higher proportion of males among newborn infants born to mothers with panic diseases compared to newborn infants of mothers without panic disorders. Pregnant women with panic disorders had a shorter (0.4 week) gestational age (adjusted t = 2.3; p = 0.02) and a larger proportion of preterm births (17.1% versus 9.1%) (adjusted POR with 95% CI = 1.9, 1.3–2.8). However, there was no significant difference in the mean birth weight and rate of low birthweight between the two study groups. Conclusion Panic disorders during pregnancy were associated with anemia, a shorter gestational age and a larger proportion of preterm birth. Further studies are needed to confirm and explain or disprove the male excess among newborn infants born to mothers with panic disorders.

Objective The objective of the investigation was to study the possible association between uterus uni- or bicornis in pregnant women and structural birth defects (ie, congenital abnormalities) in their offspring. Study Design There were 22,843 cases with congenital abnormality recorded in the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. These subjects were matched to 38,151 controls without any defect. Prevalence of medically recorded uterus uni/bicornis in the prenatal maternity logbook in the mothers of subjects with different congenital abnormalities and of their matched controls without any defect were compared. Results Fifty-seven (0.25%) subjects and 67 (0.18%) controls had mothers with uterus uni/bicornis. There was a significant association of uterus uni/bicornis in pregnant women with a higher risk of total group of congenital abnormalities (adjusted odds ratio, 1.5; 95% confidence interval, 1.1–2.2) explained mainly by a significantly higher risk of clubfoot and particularly postural deformity association in their children (adjusted odds ratio, 4.7; 95% confidence interval, 2.4–9.1). Conclusion Pregnant women with a uni/bicornis uterus have a significantly higher risk of clubfoot and postural deformity association.