Podophyllotoxin use appears safe during pregnancy

  • Andersson NW & al.
  • JAMA Dermatol
  • 08/01/2020

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Local podophyllotoxin use is not associated with increased risk for adverse pregnancy outcomes, according to this cohort study of over 1.6 million pregnancies.

Why this matters

  • Podophyllotoxin is primarily used for local treatment of anogenital warts, but potential fetal safety risk was poorly studied.

Key results

  • Rates of major birth defects were similar between podophyllotoxin-exposed and unexposed pregnancies:
    • Overall: 3.5% vs 3.4%;
      • OR, 1.02 (95% CI, 0.69-1.50).
    • Spontaneous abortion: 8.3% vs 9.6%;
      • HR, 0.87 (95% CI, 0.73-1.04).
    • Preterm birth: 8.1% vs 7.5%;
      • OR, 1.08 (95% CI, 0.86-1.35).
    • Small-for-gestational-age size: 12.5% vs 12.4%;
      • OR, 1.01 (95% CI, 0.85-1.22). 
    • Stillbirth: 0.2% vs 0.3%;
      • HR, 0.58 (95% CI, 0.18-1.86).

Study design

  • From a cohort of 1,650,649 pregnancies, podophyllotoxin-exposed pregnancies were propensity-scored matched in a 1:10 ratio with unexposed pregnancies.
  • 9229 pregnancies were included for the analyses of major birth defects.
  • 18,590 pregnancies were included for the analyses of spontaneous abortions.
  • Funding: None disclosed.

Limitations

  • Observational study of large database.