Study links hormones with birth risk

Press, Volume CXIV, Issue 33676, 28 October 1974, Page 6

Study links hormones with birth risk

(By

JANE E. BRODY

in the "New Y'ork Times.”)

A study by the New York State Health Department indicates that women exposed early in pregnancy to oral synthetic hormones, such as those in birth control pills or certain pregnancy tests, may face an increased risk of bearing infants with birth defects.

The author of the study i emphasised, however, that the risk was apparently very low and, most women who were exposed to the hormones early in pregnancy gave birth to normal, healthy infants. But, even with a low risk, the findings are important because so many women are potentially at risk of earlypregnancy hormone exposure, the author, Dr Dwight Janerich, says. His findings, which link defects of the arms and legs to exposure to the hormones estrogen and progestogen are supported by earlier preliminary reports of an association between these hori mones when taken by the i mother in the first month of [pregnancy and the occurrence of birth defects of the I heart, anus, vertebral coli umn, trachea and oesophagus, as well as the limbs. [ Dr Janerich, an epidemi- [ ologist at the state’s Birth I Defects Institute in Albany, recommends on the basis of

i these findings that no woman be given hormonal pregnancy tests, especially since many alternatives are available, and that greater care be taken in prescribing and using birth control pills. The findings were released by the health department and appear in “The New England Journal of Medicine.” An accompanying editorial by Dr James J. and Dr Audrey H. Nora recommends that women be given pregnancy tests before they start taking oral contraceptives. Dr Janerich added in an interview that it would also be wise if women who stopped the pill because they wanted to become pregnant used another method of contraception for at least one month and preferably three months before (attempting to conceive. By i this time, any residual hormones from the pill should be cleared from the system, he explained. LIMB DEFECTS In his study, Dr Janerich examined the pregnancy histories of 108 women who bore infants with limb defects, ranging from a missing finger or toe to a missing arm or leg, and compared these histories with a comparable group of

108 women who bore normkl infants.

Fourteen per cent of the women with defective infants- had been exposed to hormones whereas only 14 per cent of those with normal children had such exposure. Exposure occurred either as a result of a pregnancy test with oral progestogen, the unwitting continuance of birth control pills after pregnancy had occurred or the treatment with hormones for vaginal bleeding early in pregnancy.

Dr Janerich concluded that the risk of bearing defective infants was 4.7 times greater for women with such hormone exposure.

In the population as a whole, the defects are quite rare, with an incidence in New York State of 24 per 100,000 births in 1973. However, as might be expected if they are sometimes associated with pill use, the incidence has increased by 33 per cent since a decade ago, al the ugh birth defects in general have' declined by 6 per cent during that period. Dr Janerich says that male foetuses seem to be especially vulnerable to the hormone-associated defects. All those in his study turned out to be boys. In previous studies, most of the affected infants were also males.