Use of specified critical periods of different congenital abnormalities instead of the first trimester concept

Czeizel, Andr̀ew E.; Puhó, Erzsébet; Ács, Nándor; Bánhidy, Ferenc

doi:10.1002/bdra.20431

Cited by 43 publications

(58 citation statements)

References 11 publications

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“…There was no information on dosage or length of exposure to SSRIsBerard et al [37] suggested that the teratogenic effect of paroxetine may be limited to higher doses (25mg/day). We assumed, as is customary, that the relevant exposure window was the first trimester (as these are the available EUROCAT data) but this window is wider than the sensitive period for many congenital anomalies, some congenital anomalies may occur after later exposures [81]. On the other hand, some of the exposures recorded do not specify timing precisely and may be misattributed to the first trimester, although we verified timing for anomalies where significant associations were found.…”

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confidence: 90%

Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study

et al. 2015

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Dolk, H. (2015). Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study. European Journal of Epidemiology, 30(11), 1187-1198. https://doi.org/10.1007/s10654-015-0065-y General rights Copyright for the publications made accessible via the Queen's University Belfast Research Portal is retained by the author(s) and / or other copyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associated with these rights.

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Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study

et al. 2015

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“…Detrimental effects of prenatal exposure to fever might be diluted if too-broad time intervals of exposure are used in the analyses. Czeizel et al 61 suggested that future research in this area should consider critical exposure periods as specific as possible to the outcome of interest and not rely only on commonly used indicators of time, such as trimesters. We found most evidence to support a harmful effect of fever in the early stages of pregnancy.…”

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confidence: 99%

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

2014

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BACKGROUND AND OBJECTIVE: Fever during pregnancy has been suspected to harm the developing fetus. However, until now, no systematic analysis of the available evidence has been undertaken to assess the impact of maternal fever on health outcomes in the child. The goal of this study was to systematically review evidence from epidemiologic studies on adverse health outcomes of the offspring in relation to exposure to maternal fever during pregnancy. METHODS: Systematic searches in PubMed, Web of Science, and the Cochrane Library were performed by using Medical Subject Headings, Boolean operators, and truncation, and references of references were reviewed. Cohort and case-control studies addressing health outcomes of prenatal fever exposure in humans were eligible for inclusion. Studies with no direct reference to fever, studies in selected populations (eg, preterm births), and studies published before 1990 were excluded. RESULTS: The available literature supported an increased risk of adverse offspring health in association with fever during pregnancy. The strongest evidence was available for neural tube defects, congenital heart defects, and oral clefts, in which meta-analyses suggested between a 1.5- and nearly 3-fold increased risk with fever exposure in the first trimester. We did not find strong evidence of a dose–response relationship, but there was some evidence that antipyretic medications may have a protective effect when used in relation to febrile episodes. CONCLUSIONS: We found substantial evidence to support the contention that maternal fever during pregnancy may negatively affect offspring health. The harmful effects seemed to cover both short- and longer-term health outcomes; however, for several outcomes, the evidence was insufficient to judge any association.

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“…The second time interval was the second and third months of gestation. This is the sensitive 'critical period' for most major CAs [Czeizel et al 2008]. The third time interval was the fourth to ninth months of gestation, that is, pregnancy after the organforming period.…”

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confidence: 99%

No association of maternal vitamin E intake with higher risk of cardiovascular malformations in children: a population-based case–control study

Szilasi

Bártfai²,

Bártfai³

et al. 2011

Therapeutic Advances in Drug Safety

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Abstract:Objective: In Hungary, vitamin E is frequently used to prevent repeated or threatened abortion. A previous study showed a higher risk of cardiovascular malformations in the children of pregnant women who had a high vitamin E intake either in their diet or by taking supplements. The objective was to examine this association. Methods: The Hungarian CaseControl Surveillance System of Congenital Abnormalities, 19801996, is a large, population-based dataset including 22,843 cases with congenital abnormalities, 38,151 healthy controls matched to the cases, and 834 patient controls with Down syndrome. Vitamin E treatment was compared in the mothers of these children. Results: The mothers of 1418 cases with congenital abnormalities (6.2%), 2267 controls (6.0%) and 43 patient controls (5.2%) had vitamin E treatment during pregnancy. A preliminary comparison of cases and controls showed a higher risk for four congenital abnormality groups, including cardiovascular malformations. However, if only prospectively and medically recorded vitamin E treatments in the prenatal maternity logbook were evaluated during the critical period of different congenital abnormalities, the higher risk for these congenital abnormalities was not found. Conclusions:The results of this study were based on relatively high-dose vitamin E intake in pregnant women and were not able to confirm the previously reported teratogenic effect of vitamin E.

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Use of specified critical periods of different congenital abnormalities instead of the first trimester concept

Cited by 43 publications

References 11 publications

Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study

Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

No association of maternal vitamin E intake with higher risk of cardiovascular malformations in children: a population-based case–control study

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