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Pyloric stenosis and maternal Bendectin exposure
Insights
Maternal Bendectin use during pregnancy may increase the risk of infantile hypertrophic pyloric stenosis. Higher Bendectin prescription numbers correlated with a greater risk for this infant condition.
Area of Science:
- Pediatric Health
- Obstetrics and Gynecology
- Pharmacoepidemiology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) is a congenital disorder requiring surgical correction.
- Understanding potential environmental or medication-related risk factors for IHPS is crucial for prevention and early intervention.
Purpose of the Study:
- To investigate the association between maternal Bendectin use in the first trimester and the development of IHPS in infants.
- To explore if the dosage or frequency of Bendectin exposure influences the risk of IHPS.
Main Methods:
- A retrospective cohort study was conducted using data from Group Health Cooperative of Puget Sound.
- Infants diagnosed with pyloric stenosis between 1977 and 1982 were identified.
- Maternal pharmacy records were analyzed to determine Bendectin exposure during the first trimester of pregnancy.
Main Results:
- A risk ratio of 2.5 (95% CI 1.2-5.2) was observed for IHPS in infants whose mothers used Bendectin during pregnancy.
- A dose-response relationship was found: women with five or more Bendectin prescriptions had a relative risk of 7.6 (95% CI 4.9-11.6) compared to non-exposed mothers.
- Women with one Bendectin prescription had a relative risk of 1.2 (95% CI 0.4-4.4).
Conclusions:
- Maternal Bendectin use during the first trimester of pregnancy is associated with an increased risk of infantile hypertrophic pyloric stenosis.
- The risk of IHPS appears to be dose-dependent, with higher Bendectin exposure correlating with a greater risk.
- Further research may be warranted to confirm these findings and explore underlying mechanisms.
Abstract:
As part of a long-term follow-up of structural disorders present at birth or shortly thereafter in infants born at Group Health Cooperative of Puget Sound, all infants with a diagnosis of pyloric stenosis born between July 1, 1977 and June 30, 1982, were identified. Automated pharmacy profiles were examined to determine whether an association between maternal Bendectin use in the first trimester and infantile hypertrophic pyloric stenosis existed. Among the 3,835 women exposed to Bendectin while pregnant, in this group of 13,346 births, 13 had infants who developed pyloric stenosis, and among the 9,511 women not exposed, 13 had infants who developed pyloric stenosis, resulting in a risk ratio estimate of 2.5 (95% confidence interval (CI) 1.2-5.2). When mothers were divided according to the number of prescriptions for Bendectin filled, the relative risk estimate increased from 1.2 (95% CI 0.4-4.4) in women who filled only one prescription to 7.6 (95% CI 4.9-11.6) in women who filled five or more prescriptions for Bendectin during their pregnancy.