Second Chapter
Dr. Álvaro Monterrosa Castro, MD
Relationship between oral contraceptives and skeletal congenital defects
There has always been speculation about the relationship between oral contraceptives and skeletal congenital defects, but it has been pointed out that it was a statistically non-significant study and that its results have not been confirmed in other evaluations (6).
In prospective studies, no relationship has been observed between sexual steroids and the appearance of anomalies of the VACTERL complex (vertebral, anal, cardiac, tracheoesophageal, renal and extremity malformations, nor have they been related to hypospadias or mutagenic effects that could be responsible for chromosomally abnormal fetuses (7).
(Read Also: Oral Contraception in Perspective, Other Various Effects)
A very small positive association has been reported between oral contraceptives and heart defects:
When the pill is taken in the initial period of embryonic development, the relative risk increases by 2, however Bracken in 1990 (159) reported in a meta-analysis of 26 prospective studies, where they compared 6,102 exposed to combined oral contraceptives and 85,167 unexposed, observing no increase in the overall risk of malformations, congenital heart disease or limb defects.
The issue seems to be limited to the use of the pill in early pregnancy; no malformations have been observed in subsequent births in women who discontinued oral contraception.
There is no increase in the rates of chromosomal abnormalities or spontaneous abortions. Bukvic et al (160), based on in-vitro studies, establishes that the application of ethinyl estradiol plus norgestrel in a ratio of 1:5 does not induce structural chromosomal aberrations in cultures of human lymphocytes and fibroblasts.
There is no reason to recommend that women delay their attempts to conceive until one or two months after stopping use of the pill. It must be informed
Sufficiently inform users of combined oral contraceptives who become pregnant while taking it or those who accidentally take it at the beginning of a pregnancy, that the risk of congenital anomalies is not significantly higher than the general population rate, that is, 2 – 3% (7).
Dr. Álvaro Monterrosa Castro, MD
