Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1988 Mar;42(1):1–7. doi: 10.1136/jech.42.1.1

Maternal drug histories and congenital malformations: limb reduction defects and oral clefts.

L Hill 1, M Murphy 1, M McDowall 1, A H Paul 1
PMCID: PMC1052672  PMID: 3418278

Abstract

In a case control study, prescription data were examined for the three months before the last menstrual period and for the first trimester of pregnancy in (a) 115 mothers of children with limb reduction defects, (b) 676 mothers of children with oral cleft, and (c) an equal number of control mothers of normal babies from the same doctor's practice for each case. In the limb reduction study, the study mothers were prescribed more drugs generally although this did not reach statistical significance, nor were there significant differences between study and control mothers for individual groups of drugs. In the oral cleft study, significantly more drugs were prescribed to study mothers in the three months before the last menstrual period, and a similar trend, which did not reach statistical significance, was observed in the first trimester. Anticonvulsant drugs were prescribed significantly more frequently to study mothers during the whole period of the study. A significant association was also demonstrated between oral contraceptives taken in the three months before the last menstrual period and oral cleft, but doubt must remain concerning this relationship; the risk is not well understood and is likely to be nonspecific. A number of other significant associations were identified, although their importance in practice is uncertain in view of the confounding factors that may affect a study of this kind.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brogan W. F. Letter: Cleft lip and palate and pregnancy tests. Med J Aust. 1975 Jan 11;1(2):44–44. [PubMed] [Google Scholar]
  2. Ericson A., Källén B., Westerholm P. Cigarette smoking as an etiologic factor in cleft lip and palate. Am J Obstet Gynecol. 1979 Oct 1;135(3):348–351. doi: 10.1016/0002-9378(79)90703-8. [DOI] [PubMed] [Google Scholar]
  3. FRASER F. C., FAINSTAT T. D. Production of congenital defects in the off-spring of pregnant mice treated with cortisone; progress report. Pediatrics. 1951 Oct;8(4):527–533. [PubMed] [Google Scholar]
  4. Golding J., Vivian S., Baldwin J. A. Maternal anti-nauseants and clefts of lip and palate. Hum Toxicol. 1983 Jan;2(1):63–73. doi: 10.1177/096032718300200105. [DOI] [PubMed] [Google Scholar]
  5. Greenberg G., Inman W. H., Weatherall J. A., Adelstein A. M., Haskey J. C. Maternal drug histories and congenital abnormalities. Br Med J. 1977 Oct 1;2(6091):853–856. doi: 10.1136/bmj.2.6091.853. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hanson J. W., Smith D. W. The fetal hydantoin syndrome. J Pediatr. 1975 Aug;87(2):285–290. doi: 10.1016/s0022-3476(75)80604-4. [DOI] [PubMed] [Google Scholar]
  7. Harlap S., Prywes R., Davies A. M. Letter: Birth defects and oestrogens and progesterones in pregnancy. Lancet. 1975 Mar 22;1(7908):682–683. doi: 10.1016/s0140-6736(75)91784-5. [DOI] [PubMed] [Google Scholar]
  8. Hay S. Incidence of clefts and parental age. Cleft Palate J. 1967 Jul;4:205–213. [PubMed] [Google Scholar]
  9. Heinonen O. P., Slone D., Monson R. R., Hook E. B., Shapiro S. Cardiovascular birth defects and antenatal exposure to female sex hormones. N Engl J Med. 1977 Jan 13;296(2):67–70. doi: 10.1056/NEJM197701132960202. [DOI] [PubMed] [Google Scholar]
  10. Hemminki K., Mutanen P., Saloniemi I. Smoking and the occurrence of congenital malformations and spontaneous abortions: multivariate analysis. Am J Obstet Gynecol. 1983 Jan 1;145(1):61–66. doi: 10.1016/0002-9378(83)90340-x. [DOI] [PubMed] [Google Scholar]
  11. Janerich D. T., Piper J. M., Glebatis D. M. Oral contraceptives and congenital limb-reduction defects. N Engl J Med. 1974 Oct 3;291(14):697–700. doi: 10.1056/NEJM197410032911403. [DOI] [PubMed] [Google Scholar]
  12. Lammer E. J., Cordero J. F. Exogenous sex hormone exposure and the risk for major malformations. JAMA. 1986 Jun 13;255(22):3128–3132. [PubMed] [Google Scholar]
  13. Mastroiacovo P., Bertollini R., Morandini S., Segni G. Maternal epilepsy, valproate exposure, and birth defects. Lancet. 1983 Dec 24;2(8365-66):1499–1499. doi: 10.1016/s0140-6736(83)90844-9. [DOI] [PubMed] [Google Scholar]
  14. McCredie J., Kricker A., Elliott J., Forrest J. Congenital limb defects and the pill. Lancet. 1983 Sep 10;2(8350):623–623. doi: 10.1016/s0140-6736(83)90705-5. [DOI] [PubMed] [Google Scholar]
  15. Meadow R. The teratogenicity of epilepsy. Dev Med Child Neurol. 1974 Jun;16(3):375–376. doi: 10.1111/j.1469-8749.1974.tb03352.x. [DOI] [PubMed] [Google Scholar]
  16. Rothman K. J., Louik C. Oral contraceptives and birth defects. N Engl J Med. 1978 Sep 7;299(10):522–524. doi: 10.1056/NEJM197809072991006. [DOI] [PubMed] [Google Scholar]
  17. Rubin P. C., Craig G. F., Gavin K., Sumner D. Prospective survey of use of therapeutic drugs, alcohol, and cigarettes during pregnancy. Br Med J (Clin Res Ed) 1986 Jan 11;292(6513):81–83. doi: 10.1136/bmj.292.6513.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Savolainen E., Saksela E., Saxén L. Teratogenic hazards of oral contraceptives analyzed in a national malformation register. Am J Obstet Gynecol. 1981 Jul 1;140(5):521–524. doi: 10.1016/0002-9378(81)90227-1. [DOI] [PubMed] [Google Scholar]
  19. Saxén I. Epidemiology of cleft lip and palate. An attempt to rule out chance correlations. Br J Prev Soc Med. 1975 Jun;29(2):103–110. [PMC free article] [PubMed] [Google Scholar]
  20. Saxén I. Letter: Cleft palate and maternal diphenhydramine intake. Lancet. 1974 Mar 9;1(7854):407–408. doi: 10.1016/s0140-6736(74)93172-9. [DOI] [PubMed] [Google Scholar]
  21. Shields E. D., Bixler D., Fogh-Andersen P. Cleft palate: a genetic and epidemiologic investigation. Clin Genet. 1981 Jul;20(1):13–24. doi: 10.1111/j.1399-0004.1981.tb01800.x. [DOI] [PubMed] [Google Scholar]
  22. Speidel B. D., Meadow S. R. Maternal epilepsy and abnormalities of the fetus and newborn. Lancet. 1972 Oct 21;2(7782):839–843. doi: 10.1016/s0140-6736(72)92209-x. [DOI] [PubMed] [Google Scholar]
  23. Vessey M., Meisler L., Flavel R., Yeates D. Outcome of pregnancy in women using different methods of contraception. Br J Obstet Gynaecol. 1979 Jul;86(7):548–556. doi: 10.1111/j.1471-0528.1979.tb10808.x. [DOI] [PubMed] [Google Scholar]
  24. Walker B. E. Cleft Palate Produced in Mice by Human-Equivalent Dosage with Triamcinolone. Science. 1965 Aug 20;149(3686):862–863. doi: 10.1126/science.149.3686.862. [DOI] [PubMed] [Google Scholar]
  25. Winship K. A., Cahal D. A., Weber J. C., Griffin J. P. Maternal drug histories and central nervous system anomalies. Arch Dis Child. 1984 Nov;59(11):1052–1060. doi: 10.1136/adc.59.11.1052. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES