Decongestant Use During Pregnancy and Its Association With Preterm Delivery

Birth Defects Res A Clin Mol Teratol. 2010 Sep;88(9):715-21. doi: 10.1002/bdra.20699.


Background: Despite the frequent intake of decongestants during pregnancy, only one study to date has evaluated the association of decongestants with preterm delivery, and it identified a reduced risk. We examined this association in more detail.

Methods: Using a population-based random sample of 3271 Massachusetts live-born births without major malformations, we categorized decongestant exposure according to timing, frequency of use, route, and indication. Preterm birth was defined as a gestational age of <37 completed weeks. We estimated hazard ratios and examined confounding by indication by examining various strata of women and through multivariate adjustment.

Results: Compared to nonexposed women, those who took decongestants during the second or third trimester only were less likely to experience preterm delivery (HR, 0.42; 95% CI, 0.21-0.84). This association was observed only for women without preeclampsia.

Conclusions: A protective association between decongestant use and preterm delivery has now been observed in two studies; however, the possibility of confounding by underlying condition remains.

MeSH terms

  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Delivery, Obstetric
  • Female
  • Gestational Age
  • Humans
  • Massachusetts
  • Nasal Decongestants / therapeutic use*
  • Obstetric Labor, Premature*
  • Parturition / drug effects*
  • Phenylpropanolamine / therapeutic use
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Pseudoephedrine / therapeutic use
  • Retrospective Studies
  • Rhinitis / drug therapy*
  • Risk Factors
  • Surveys and Questionnaires


  • Nasal Decongestants
  • Phenylpropanolamine
  • Pseudoephedrine