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Therapeutic drugs in early pregnancy and congenital defects
1Department of Epidemiology and Biostatistics and School of Occupational Health, McGill University, Montreal, Quebec, Canada.
In a study of occupation and pregnancy outcome, information was collected on certain non-occupational factors including therapeutic drugs taken in the first trimester, reported by some 17% of women. A case-referent analysis was made of data from pregnancies leading to 787 major (class 1) and 2386 miscellaneous minor (class 2) congenital defects compared with pregnancies without defects, matched for hospital, maternal age and educational level. In pairs discordant for one of seven drug groups, ratios of positive pairs (case with drug) to negative pairs (referent with drug) were for class 1 defects 164:148, relative risk (RR) 1.11 and for class 2 defects 433:383, RR 1.13. Only anti-infective drugs showed an increased RR: 1.70 (p = 0.06). This was mainly with nervous/sensory defects (10:2; RR 5.0, p = 0.04) but no one type of defect or type of drug was identified; the infections for which the drugs were given might have been responsible. For class 1 defects two pairs were positive for anti-convulsant drugs and two negative; no increase in risk was found for any specific drugs including doxylamine succinate (Bendectin).
In a study of occupation and pregnancy outcome, information was collected on certain non-occupational factors including therapeutic drugs taken in the first trimester, reported by some 17% of women. A case-referent analysis was made of data from pregnancies leading to 787 major (class 1) and 2386 miscellaneous minor (class 2) congenital defects compared with pregnancies without defects, matched for hospital, maternal age and educational level. In pairs discordant for one of seven drug groups, ratios of positive pairs (case with drug) to negative pairs (referent with drug) were for class 1 defects 164:148, relative risk (RR) 1.11 and for class 2 defects 433:383, RR 1.13. Only anti-infective drugs showed an increased RR: 1.70 (p = 0.06). This was mainly with nervous/sensory defects (10:2; RR 5.0, p = 0.04) but no one type of defect or type of drug was identified; the infections for which the drugs were given might have been responsible. For class 1 defects two pairs were positive for anti-convulsant drugs and two negative; no increase in risk was found for any specific drugs including doxylamine succinate (Bendectin).