Spermicide use and pregnancy outcome

Abstract

The relation between periconceptional vaginal spermicide use and sex ratio at birth, birthweight, and the frequency of congenital anomalies was examined in a cohort of 2,712 New York City obstetric patients, 149 of whom (5.5 per cent) became pregnant while using spermicides or had used spermicides before and after conception. Periconceptional spermicide use was not associated with any important variation in the expected sex ratio at birth, nor with major or minor congenital anomalies. Exposure to spermicides in the periconceptional period, defined dichotomously as present or absent, was not associated with decreased birthweight in male or female infants. There was a slight decrease in birthweight among female infants with increasing duration of postconceptional spermicide use; an estimated 7.4 grams decrease with each day of use. The size of the effect and its selectivity by sex suggest a chance finding.

PIP: A cohort of 2712 New York City obstetric patients were the subjects in a study designed to examine the relation between periconceptional vaginal spermicide use and sex ratio at birth, birthweight, and the frequency of congenital anomalies. 1902 of the women had never used spermicides; 149 women had used spermicides around the time of conception, and 661 had used spermicides but not around the time of conception. The women participated in an interview prior to delivery, usually during their 2nd trimester of pregnancy. A lifetime history of contraceptive use was obtained. Specific questions were asked about contraceptive use immediately before the last menstrual period, at the time of conception (14 days after the last menstrual period), and after conception. Women also were contacted after they delivered and asked about pregnancy outcome. Hospital records were reviewed for birthweight and information on the presence of malformations in stillbirths and infants. The infant's chart was reviewed 2 years or more after delivery in those cases where the mother or the hospital records had indicated that the baby was abnormal or had problems at birth. Women who had never used spermicides were more likely to be public patients, young, Hispanic, foreign-born, and have had less education than women who had used spermicides at some time in their lives. The sex ratio, defined as the ratio of male births to the total number of births, was .505 among women who had never used spermicides and .487 among women who had used spermicides but not around the time of conception. Among women who had used spermicides after conception, the ratio did not vary systematically with the number of exposure. There was a slight inverse association between the length of postconceptional use and birthweight among female infants but not among male infants. There were no major congenital anomalies among the offspring of women who had used spermicides in the periconceptional period. The rate of minor anomalies was slightly increased among periconceptional users but confidence limits aroung the relative risk were wide. The 4 anomalies observice in the offspring of women who had used spermicides around the time of conception were polydactyly, hemangioma, skin tags, and malformed ears. There were 2 chromosomally abnormal births among 459 recent users compared to .98 expected and 1 chromosomally abnormal birth among 263 long duration users compared to .56 expected