No link found between podophyllotoxin, adverse fetal outcomes

No association was found between exposure to podophyllotoxin during pregnancy and adverse fetal outcomes, according to a registry-based cohort study conducted in Denmark.

“In our study, local podophyllotoxin use during pregnancy did not appear to be associated with an increased risk of adverse fetal outcomes, including major birth defects, spontaneous abortions, preterm births, small-for-gestational-age size and stillbirths,” Niklas Worm Andersson, MD, of the department of clinical pharmacology at Copenhagen University Hospital Bispebjerg and Frederiksberg in Denmark, told Healio.

Researchers evaluated data on live birth and fetal death pregnancies through the Medical Birth Registry and the National Patient Registry from Jan. 1, 1997, to Dec. 31, 2016. Exposure was defined as having a prescription for podophyllotoxin.

In total, 1,650,649 pregnancies were eligible for inclusion in the study.

 

No association was found between exposure to podophyllotoxin during pregnancy and adverse fetal outcomes, according to a registry-based cohort study.

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Five matched study cohorts, each including podophyllotoxin-exposed and unexposed pregnancies, included a total of 9,229 pregnancies for the analysis of major birth defects, 18,590 pregnancies for spontaneous abortions, 12,518 pregnancies for preterm births, 12,738 pregnancies for small-for-gestational-age size and 20,856 pregnancies for stillbirths.

In the first year of life, 29 infants (3.5%) from podophyllotoxin-exposed pregnancies were diagnosed with a major birth defect compared with 286 unexposed pregnancies (3.4%) (OR = 1.02; 95% CI, 0.69-1.50). In total, 141 podophyllotoxin-exposed pregnancies (8.3%) ended in a spontaneous abortion compared with 1,626 unexposed pregnancies (9.6%) (HR = 0.87; 95% CI, 0.73-1.04).

There was no statistically significant association between podophyllotoxin exposure in pregnancy and preterm birth and stillbirth compared with unexposed pregnancies.

“While our findings may support future recommendations for clinical decision-making regarding treatment of anogenital warts during pregnancy when indicated, these first-time published observational findings should be confirmed in other independent populations,” Andersson said. – by Erin T. Welsh

Disclosures: The authors report no relevant financial disclosures.