Skip to main content
SpringerLink
Log in

Spermicides, hormonal contraception and congenital malformations

  • Published:
Advances in Contraception

Abstract

Allegations that inadvertent pregnancies in contraceptive users are associated with congenital anomalies continue to be common. In 1985, a review by one of us concluded that there is little or no scientific basis for such claims [1]. Since then, additional data have substantiated this conclusion, particularly with respect to spermicides and hormonal contraception. The purpose of this review is to update information with respect to potential teratogenicity for these two contraceptive methods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SimpsonJ.L. (1985). Relationship between congenital anomalies and contraception.Adv. Contracept.,1, 3

    PubMed  Google Scholar 

  2. DoeringP.L. and StewartR.B. (1978). The extent and character of drug consumption during pregnancy.J. Am. Med. Assoc.,239, 843

    Google Scholar 

  3. SimpsonJ.L., MillsJ.L., MoreyA. et al. (1989). Drug ingestion during pregnancy: infrequent exposure in a contemporary United States sample.Am. J. Perinatol.,6, 244

    PubMed  Google Scholar 

  4. Wiseman, R.A. (1985). Negative correlation between sex hormone usage and malformations. In:Prevention of Physical and Mental Congenital Defects, Part C: Basic and Medical Science, Education, and Future Strategies, Alan R. Liss, Inc., p. 171

  5. SimpsonJ.L. and GolbusM.S. (1990).Genetics in Obstetrics and Gynecology, 2nd edn. Saunders, Philadelphia (in press)

    Google Scholar 

  6. LevyE.P., CohenA. and FraserF.C. (1973). Hormone treatment during pregnancy and congenital heart disease.Lancet,1, 611

    Google Scholar 

  7. Nora, J.J. and Nora, A.H. (1973). Preliminary evidence for a possible association between oral contraceptives and birth defects.Teratology,7, A24

    Google Scholar 

  8. NoraJ.J., NoraA.H., BlumJ., IngramJ., FountainA., PetersonM., LortscherR.H. and KimberlingW.J. (1978). Exogenous progestogen and estrogen implicated in birth defects.J. Am. Med. Assoc.,240, 837

    Google Scholar 

  9. JanerichD.T., DuganJ.M., StandfastS.J. and StriteL. (1977). Congenital heart disease and prenatal exposure to exogenous sex hormones.Br. Med. J.,1, 1058

    PubMed  Google Scholar 

  10. GreenbergG., InmanW.H.W., WeatherallJ.A.C., AdelsteinA.M. and HaskeyJ.C. (1977). Maternal drug histories and congenital abnormalities.Br. Med. J.,2, 853

    PubMed  Google Scholar 

  11. BrackenM.D., HolfordT.R., WhiteC. and KelseyJ.L. (1978). Role of oral contraception in congenital malformations of offspring.Int. J. Epidemiol.,7, 309

    PubMed  Google Scholar 

  12. HeinonenO.P., SloneD., MonsonR.R., HookE.B. and ShapiroS. (1976). Cardiovascular birth defects in antenatal exposure to female sex hormones.N. Engl. J. Med.,296, 67

    Google Scholar 

  13. HeinonenO.P., SloneD. and ShapiroS. (1977).Birth Defects and Drugs in Pregnancy. Sciences Group, Littleton, Mass.

    Google Scholar 

  14. WisemanR.A. and Dodds-SmithI.C. (1984). Cardiovascular birth defects and antenatal exposure to female sex hormones: a reevaluation of some base data.Teratology,30, 359

    PubMed  Google Scholar 

  15. HarlapS., PrywesR. and DaviesA.M. (1975). Birth defects and estrogens and progesterones in pregnancy.Lancet,1, 682

    PubMed  Google Scholar 

  16. HarlapS., ShionoP.H. and RamcharanS. (1985). Congenital abnormalities in the offspring of women who used oral and other contraceptives around the time of conception.Int. J. Fertil.,30, 39

    PubMed  Google Scholar 

  17. SpiraN., GoujardJ., HuelG. and Rumeau-RouquetteC. (1972). Etude teratogene des hormones sexuelles. Premiers resultats d'une enquete epidemiologique portant sur 20,000 femmes.Rev. Red. Fr.,41, 2683

    Google Scholar 

  18. GoujardJ. and Rumeau-RouquetteC. (1977). First trimester exposure to progestogen/estrogen and congenital malformations.Lancet,1, 482

    PubMed  Google Scholar 

  19. GoujardJ., Rumeau-RouquetteC. and CubizallesM.J. (1979). Tests hormonaux de grossesse et malformations congenitales.J. Gynecol. Obstet. Reprod.,8, 489

    Google Scholar 

  20. SavolainenE., SakselaE. and SaxenL. (1981). Teratogenic hazards of oral contraceptives analyzed in a national malformation register.Am. J. Obstet. Gynecol.,140, 521

    PubMed  Google Scholar 

  21. MichaelisJ., MichaelisH., GluckE. and KollerS. (1983). Prospective study of suspected associations between certain drugs administered during early pregnancy and congenital malformations.Teratology,27, 57

    PubMed  Google Scholar 

  22. KullanderS. and KöllenB. (1976). A prospective study of drugs and pregnancy.Acta Obstet. Gynecol. Scand.,55, 221

    PubMed  Google Scholar 

  23. Royal College of General Practitioners. (1976). The outcome of pregnancy in former oral contraceptive users.Br. J. Obstet. Gynaecol.,83, 608

    Google Scholar 

  24. VarmaT.R. and MorsmanJ. (1982). Evaluation of the early use of proluton-depot (Hydroxyprogesterone hexamoate) in early pregnancy.Int. J. Gynaecol. Obstet.,20, 13

    PubMed  Google Scholar 

  25. VesseyM.P. (1979). Outcome of pregnancy in women using different methods of contraception.Br. J. Obstet. Gynaecol.,86, 548

    PubMed  Google Scholar 

  26. TorfsC., MilkovichL. and Van DenBergB.J. (1981). The relationship between hormonal pregnancy tests and congenital abnormalities: a prospective study.Am. J. Epidemiol.,113, 563

    PubMed  Google Scholar 

  27. LinnS., SchoenbaumS.C., MonsonR.R. et al. (1983). Lack of association between contraceptive usage and congenital malformations in offspring.Am. J. Obstet. Gynecol.,147, 923

    PubMed  Google Scholar 

  28. NishimuraH., UwabeC. and SembaR. (1974). Examination of teratogenicity of progestogens and/or estrogens by observation of the induced abortuses.Teratology,10, 93

    Google Scholar 

  29. KatzZ., LancetM., SkornikJ., ChemkeJ., MogilnerB.M. and KlinbergM. (1985). Teratogenicity of progestogens given during the first trimester of pregnancy.Obstet. Gynaecol.,65, 775

    Google Scholar 

  30. ResseguieL.J., HickJ.F., BruenJ.A., NollerK.L., O'FallonW.M. and KurlandL.T. (1985). Congenital malformations among offspring exposed in utero to progestins, Olmstead County, Minnesota, 1936–1974.Fetil. Steril.,43, 514

    Google Scholar 

  31. CheckJ.H., RankinA. and TeichmanM. (1986). The risk of fetal anomalies as a result of progesterone therapy during pregnancy.Fertil. Steril.,45, 575

    PubMed  Google Scholar 

  32. PardthaisongT., GrayR.H., McDanielE.B. and ChandachamA. (1988). Steroid contraceptive use and pregnancy outcome.Teratology,38, 51.

    PubMed  Google Scholar 

  33. YovichJ.L., TurnerS.R. and PivetR.D. (1988). Medroxyprogesterone acetate therapy in early pregnancy has no apparent fetal effects.Teratology,38, 135

    PubMed  Google Scholar 

  34. 54 Fed. Reg. 1263 (Jan. 12, 1989)

  35. HoymeH.E., JonesK.L., VanAllenM.I., SaundersB.S. and BenirschkeK. (1982). Vascular pathogenesis of transverse limb reduction defects.J. Pediatr.,101, 839

    PubMed  Google Scholar 

  36. HechtJ.T. and ScottC.I.Jr. (1984). Genetic study of an orthopedic referral center.J. Pediatr. Orthop.,4, 208.

    PubMed  Google Scholar 

  37. PilarskiR.T., PauliR.M. and EngberW.D. (1985). Hand reduction malformations: Genetic and syndrome analysis.J. Pediatr. Orthop.,5, 274

    PubMed  Google Scholar 

  38. Freire-MaiaA. (1975). Genetics of acheiropodia (‘the handless and footless families of Brazil’) VIII. Penetrance and expressivity.Clin. Genet.,7, 98

    PubMed  Google Scholar 

  39. CalzolariE., ManservigiD., GaraniG.P., CocciG., MagnaniC. and MilanM. (1990). Limb reduction defects in Emila Romagna, Italy. Epidemiological and genetic study in 173 109 consecutive births.J. Med. Genet.,27, 353

    PubMed  Google Scholar 

  40. JanerichD.T., PiperJ.M. and GlebatisD.M. (1974). Oral contraceptives and congenital limb-reduction defects.N. Engl. J. Med.,291, 697

    PubMed  Google Scholar 

  41. KrickerA., ElliotJ.W., ForrestJ.M. and McCredieJ. (1986). Congenital limb reduction deformities and use of oral contraceptives.Am. J. Obstet. Gynecol.,155, 1072

    PubMed  Google Scholar 

  42. OakleyG.P., FlyntnJ.W. and FalekA. (1973). Hormonal pregnancy tests and congenital malformations.Lancet,2, 256

    Google Scholar 

  43. LammerE.J. and CorderoJ.F. (1986). Exogenous sex hormone exposure and the risk for major malformation.J. Am. Med. Assoc.,255, 3128

    Google Scholar 

  44. BauerS.B., RetikA.B. and ColodnyA.H. (1981). Genetic aspects of hypospadias.Urol. Clin. N. Am.,8(3), 559

    Google Scholar 

  45. AarskogD. (1971). Maternal progestins as a possible cause of hypospadias.N. Engl. J. Med.,300, 75

    Google Scholar 

  46. MonteleoneR.N., CastillaE.E. and PazJ.E. (1981). Hypospadias: an epidemiologic study in Latin America.Am. J. Med. Genet.,10, 5

    PubMed  Google Scholar 

  47. CzeizelA., TrothJ. and EordiE. (1979). Aetiological studies of hypospadias in Hungary.Hum. Hered.,29, 166

    PubMed  Google Scholar 

  48. SweetR.A., SchrootH.G., KurlandR. and CulpO.S. (1974). Study of the incidence of hypospadias in Rochester, Minnesota, 1940–1970, and a case-control comparison of possible etiologic factors.Mayo Clin. Proc.,49, 52

    PubMed  Google Scholar 

  49. AvellanL. (1977). On aetiological factors in hypospadias.Scan. J. Plast. Reconstr. Surg.,11, 115

    Google Scholar 

  50. GalI., KirmanB. and SternJ. (1967). Hormonal pregnancy tests and neural tube defects.Nature,216, 83

    Google Scholar 

  51. LaurenceM., MillerM., VowiesM., EvansK. and CarterC. (1971). Hormonal pregnancy tests and neural tube defects.Nature,233, 495

    Google Scholar 

  52. HarlapS. and EldorJ. (1980). Births following oral contraceptive failure.Obstet. Gynecol.,55, 44

    Google Scholar 

  53. DavidT.J. and O'CallaghanS.E. (1974). Birth defects and oral hormonal preparations.Lancet,1, 1238

    Google Scholar 

  54. WilsonJ.G. and BrentR.L. (1981). Are female sex hormones teratogenic?Am. J. Obstet. Gynecol.,141, 567

    PubMed  Google Scholar 

  55. World Health Organization. (1981). The effect of female sex hormones on fetal development and infant health. World Health Organization (WHO) Technical Report Series 657. WHO, Geneva

    Google Scholar 

  56. GrayR.H. (1983). Progestins in therapy. Teratogenesis. In:Progestogens in Therapy. G.Benagiano et al. eds., Raven Press, New York, p. 109

    Google Scholar 

  57. CarrD.H. (1970). Chromosome studies in selected spontaneous abortions. I. Conception after oral contraceptives.J. Can. Med. Assoc.,103, 343

    Google Scholar 

  58. BouéA. and BouéJ. (1973). Actions of steroid contraceptives on genetic material.Geburtsh Frauenheilk,33, 77

    PubMed  Google Scholar 

  59. LauritsenJ.G. (1975). The significance of oral contraceptives in causing chromosome anomalies in spontaneous abortions.Acta Obstet. Gynecol. Scand.,64, 261

    Google Scholar 

  60. AlbermanE., CreasyM., ElliotM. and SpicerC. (1976). Maternal factors associated with fetal chromosomal anomalies in spontaneous abortions.Br. J. Obstet. Gynaecol.,83, 261

    Google Scholar 

  61. DhardialR.K., MachinA.M. and TaitS.M. (1971). Chromosome anomalies in spontaneously aborted human fetuses.Lancet,2, 20

    Google Scholar 

  62. KlingerH.P., GlaserM. and KavaH.W. (1976). Contraceptives and conceptus: I, Chromosome abnormalities of the fetus and neonate related to maternal contraceptive history.Obstet. Gynecol.,48, 40

    PubMed  Google Scholar 

  63. LangR. and RedmanU. (1979). Non-mutagenicity of some sex hormones in the Ames salmonelia/microsome mutagenicity test.Mutation Res. (Amst.),67, 361

    Google Scholar 

  64. CorderoJ.F. and LaydeP.M. (1983). Vaginal spermicides, chromosomal abnormalities and limb reduction defects.Int. Family Planning Perspectives,9, 15

    Google Scholar 

  65. JickH., WalkerA.M., RothmanK.J., HunterJ.R., HunterJ.R., HolmesL.B., WatkinsR.N., D'EwartD.C., DanfordA. and MadsenS. (1981). Vaginal spermicides and congenital disorders.J. Am. Med. Assoc.,245, 1329

    Google Scholar 

  66. Wells v. Ortho Pharmaceutical Corporation, 788 F. 2d 741 (11th Cir. 1986)

  67. SmithE.S.O., DafoeC.S. and MillerJ.R. (1977). An epidemiological study of congenital reduction deformities of the limbs.Br. J. Prev. Soc. Med.,31, 39

    PubMed  Google Scholar 

  68. BrackenM.B. and VitaK. (1983). Frequency of non-hormonal contraception around conception and association with congenital malformations in offspring.Am. J. Epidemiol.,117, 281

    PubMed  Google Scholar 

  69. ShapiroS., SloneD., HeinonenO.P., KaufmanD.W., RosenbergL., MitchellA.A. and HelmrichS.P. (1982). Birth defects and vaginal spermicides.J. Am. Med. Assoc.,247, 2381

    Google Scholar 

  70. PolednakA.P., JanerichD.T., GlebatisD.M. (1982). Birth weight and birth defects in relation to maternal spermicide use.Teratology,26, 27

    PubMed  Google Scholar 

  71. HugginsG., VesseyM., FlavelR., YeatesD. and McPhersonK. (1982). Vaginal spermicides and outcome of pregnancy: findings in a large cohort study.Contraception,25, 219

    PubMed  Google Scholar 

  72. StrobinoB., KlineJ. and WarburtonD. (1988). Spermicide use and pregnancy outcome.Am. J. Public Health,78, 260

    PubMed  Google Scholar 

  73. LouikC., MitchellA.A., WerlerM.M., HansonJ.W. and ShapiroS. (1987). Maternal exposure to spermicides in relation to certain birth defects.N. Engl. J. Med.,317, 474

    PubMed  Google Scholar 

  74. MillsJ.L., HarleyE.E., ReedG.F. and BerendesH.W. (1982). Are spermicides teratogenic?J. Am. Med. Assoc.,248, 2148

    Google Scholar 

  75. FDA Drug Bulletin. (1986). Data do not support association between spermicides, birth defects.FDA Drug Bull.,16, 2

    Google Scholar 

  76. EinarsonT.R., KorenG., MatticeD. and Schechter-TsafririO. (1990). Maternal spermicide use and adverse reproductive outcome. A meta-analysis.Am. J. Obstet. Gynecol.,162, 655

    PubMed  Google Scholar 

  77. RothmanK.J. (1982). Spermicide use and Down's syndrome.Am. J. Public Health,72, 399

    PubMed  Google Scholar 

  78. WarburtonD., NeugutR.H., LustenbergerA., NicholasA.G. and KlineJ. (1987). Lack of association between spermicide use and trisomy.N. Engl. J. Med.,317, 478

    PubMed  Google Scholar 

  79. StrobinoB., KlineJ., LaiA. et al. (1986). Vaginal spermicides and spontaneous abortions of known karyotype.Am. J. Epidemiol.,123, 431

    PubMed  Google Scholar 

  80. Chez, (1978). Proceedings of the symposium ‘Progesterone, progestins, and fetal development’.Fertil Steril.,30, 16

    PubMed  Google Scholar 

  81. KalterH. and WarkanyJ. (1983). Congenital malformations: Etiologic factors and their role in prevention (part 1).N. Engl. J. Med.,308, 424

    PubMed  Google Scholar 

  82. KalterH. and WarkanyJ. (1983). Congenital malformations: Etiologic factors and their role in prevention (part 2).N. Engl. J. Med.,308, 491

    PubMed  Google Scholar 

  83. KeithL. and BergerG.S. (1977). The relationship between congenital heart defects and the use of exogenous progestational ‘contraceptive’ hormones during pregnancy: A 20 year review.Int. J. Gynaecol. Obstet.,15, 115

    PubMed  Google Scholar 

  84. SchwallieP.C. and AssenzoJ.R. (1973). Contraceptive use efficacy study using Depo provera administered as an intramuscular injection once every 90 days.Fertil. Steril.,24, 331

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 853 Jefferson Avenue, 38163, Memphis, Tennessee, USA

    J. L. Simpson & O. P. Phillips

Authors
  1. J. L. Simpson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. P. Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Simpson, J.L., Phillips, O.P. Spermicides, hormonal contraception and congenital malformations. Adv Contracept 6, 141–167 (1990). https://doi.org/10.1007/BF01849490

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01849490

Keywords

Search

Navigation