The use of drugs in mothers of offspring with neural‐tube defects

Medveczky, E; Puhó, Erzsébet; Czeizel, E

doi:10.1002/pds.900

Cited by 25 publications

(25 citation statements)

References 42 publications

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“…However, another study was unable to reproduce these results (Medveczky et al, 2004). At present, the results on non-AED drugs are still equivocal, and will require additional studies for prudent characterization with respect to their ability to induce NTDs in the human population.…”

Section: Pharmaceutical Induction Of Ntdsmentioning

confidence: 69%

Investigations into the etiology of neural tube defects

Cabrera

Hill

Etheredge

et al. 2004

Birth Defects Research Pt C

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Neural tube defects (NTDs) are serious malformations affecting approximately 1 per 1000 births, yet the mechanisms by which they arise are unknown. There have been consistent efforts in many fields of research to elucidate the etiology of this multifactorial condition. While no single gene has been identified as a major independent risk factor for NTDs, candidate genes have been proposed that may modify the effects of maternal and/or embryonic exposures. Folate supplementation effectively reduces the occurrence of NTDs and, consequently, has focused much research on metabolism of folate-related pathways during pregnancy and development. Further understanding of normal development and how teratogens can perturb these orchestrated processes also remains at the fore of modern scientific endeavors. The composite of these factors remains fragmented; the aim of this review is to provide the reader with a summary of sentinel and current works in the body of literature addressing NTD disease etiology.

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Section: Pharmaceutical Induction Of Ntdsmentioning

confidence: 69%

Investigations into the etiology of neural tube defects

Cabrera

Hill

Etheredge

et al. 2004

Birth Defects Research Pt C

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“…After title and abstract screening, 101 abstracts were selected for full text review and thirteen (nine case-control 8, 9, 11-19 and four cohort 20-23 ) studies met final inclusion criteria. We did not identify any published RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…The exposure comparison in all remaining included studies was use of oral beta-blockers versus none. All studies were conducted in developed countries: three in the US, 12, 13, 20 three in Hungary, 8, 9, 11 , three in Sweden 14, 21, 23 and one in Canada, 15-17 Germany, 18 and Serbia. 22 The timing of exposure was first trimester in all studies.…”

Section: Resultsmentioning

confidence: 99%

“…We used three data sets from Puho et al 8 for the CL/P analysis (all with the same control group) and two data sets from Medveczky et al 9 for the NT defects analysis (both with the same control group). We, therefore, performed sensitivity analyses, removing two studies at a time for the CL/P analysis and one study at a time for the NT defects analysis to assess overall robustness of the results after accounting for this multiple comparison issue.…”

Section: Methodsmentioning

confidence: 99%

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The Risk of Congenital Malformations Associated With Exposure to β-Blockers Early in Pregnancy

Yakoob

Bateman

et al. 2013

Hypertension

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Beta-blockers are commonly used during the first trimester of pregnancy. Data regarding risks of congenital anomalies in offspring have not been summarized. We performed a meta-analysis to determine teratogenicity of beta-blockers in early pregnancy. A systematic literature search was performed using PubMed, EMBASE, Cochrane Clinical Trials, and hand search. Meta-analyses were conducted using random-effects models based on odds ratios (ORs). Pre-specified subgroup analyses were performed to explore heterogeneity. Randomized controlled trials or observational studies examining risks of congenital malformations associated with first trimester beta-blocker exposure compared to no exposure were included. Thirteen population-based case-control or cohort studies were identified. Based on meta-analyses, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies (OR = 1.00; 95% CI: 0.91 – 1.10, five studies). However, in analyses examining organ-specific malformations, increased odds of cardiovascular (CV) defects (OR = 2.01; 95% CI: 1.18 – 3.42; 4 studies), cleft lip/palate (CL/P) (OR = 3.11; 95% CI: 1.79 – 5.43; 2 studies) and neural tube (NT) defects (OR = 3.56; 95% CI: 1.19 – 10.67; 2 studies) were observed. The effects on severe hypospadias were non-significant (1 study). Causality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.

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“…Medveczky et al (11) evaluated 1,202 cases of NTD and compared them to 38,151 population controls without any birth defect and 22,475 patient controls with other defects. They found an odds ratio (OR) of 2.1 (95% CI 1.0-4.5) for CC and NTD.…”

Section: Clomiphene Citratementioning

confidence: 99%