Maternal flu or fever, medications use in the first trimester and the risk for neural tube defects: a hospital-based case–control study in China

Purpose This study aims to evaluate the effects of maternal flu or fever, and medications (antibiotics and antipyretics) use in the first trimester on neural tube defects (NTDs) risk in offspring. Methods Data came from a hospital-based case–control study conducted between 2006 and 2008 in Shandong/Shanxi provinces including 459 mothers with NTD-affected births and 459 mothers without NTD-affected births. Logistic regression models were used to evaluate the effects of maternal flu, fever, and medications use on NTD risk. The effects were evaluated by adjusted odds ratio (OR) and 95 % confidence intervals (CIs) with SAS9.1.3.software. Results NTDs risks were significantly associated with maternal flu or fever (OR = 2.63, 95 % CI = 1.64–4.23) and antipyretics use (OR = 3.38, 95 % CI = 1.68–6.79), but not with antibiotics use (OR = 1.82, 95 % CI = 0.85–3.93). The risk effect of antipyretics use on anencephaly (OR = 7.81, 95 % CI = 1.96–31.13) was markedly higher than on spina bifida (OR = 3.02, 95 % CI = 1.08–8.42). Maternal flu or fever together with antipyretics use showed a higher OR for total NTDs (3.27 vs.1.87), anencephaly (7.38 vs.2.08), and spina bifida (2.97 vs.2.07) than maternal flu or fever with no antipyretics use. Conclusions Maternal flu or fever and antipyretics use in the first trimester were risk for NTDs. Maternal flu or fever together with antipyretics use increased NTD risk than only maternal flu or fever.