American Journal of Epidemiology Vol. 140, No. 3: 244-255
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Maternal Flu, Fever, and the Risk of Neural Tube Defects: A Population-based Case-Control Study
1Birth Defects and Genetic Diseases Branch, Division of Birth Defects and Developmental Disabilities, National Center for Environmental Health, National Center for Disease Control and Prevention Atlanta, GA
2Emory University School erf Public Health Atlanta, GA
Reprint requests to Dr. Michele C. Lynberg, Birth Defects and Genetic Diseases Branch, Mailstop F45, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341-3724
Results of clinical and epidemiologic studies have shown an increased risk for neural tube defects (NTD) in infants whose mothers were exposed to heat during pregnancy. However, the nsk for NTD in infants whose mothers had influenza during pregnancy has not been well studied. This population-based case-control study of infants bom in metropolitan Atlanta, Georgia, from 1968 through 1980 included 385 infants with NTD, 3,647 infants with other birth defects, and 2,676 infants without birth defects. Of the 385 mothers of case infants, 31 reported having a 2-day or longer episode of flu with fever from 1 month before through 3 months after conception (odds ratio (OR) = 3.0; 95% confidence interval (Cl) 1.9–4.7). Infants of mothers who took medications for their episodes of flu with fever had an even higher nsk for NTD (OR = 4.3, 95% Cl 2.6–7 1). When mothers of infants with birth defects other than NTD were used as controls, an increased risk of NTD remained for flu with fever (OR = 1.7, 95% Cl 1.1–2.5). There was no increased risk for NTD among the infants of mothers who reported fever from causes other than flu. Because of the heterogeneity of maternal flu, the individual contributions of infection, fever, and medications remain difficult to disentangle. Am J Epidemiol 1994, 140:244–55.
fever; influenza; neural tube defects
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