Drug Ingestion During Pregnancy: Infrequent Exposure in a Contemporary United States Sample

Jl, Simpson; Jl, Mills; Morey, Adrienne; Be, Metzger; Rh, Knopp; Lb, Holmes; Jovanovic‐Peterson, Lois; Jh, Aarons; Brown, Zane A.; M, Van Allen

doi:10.1055/s-2007-999586

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…During the last few years of the study, the incidence of one malformation -ventricular septal defectnearly doubled at a time when progestin use was declining sharply. Consistent with the observations of Wiseman [4] is the finding of only 2 progestin exposures among 729 women followed by Simpson et al [3].…”

Section: Cardiac Anomaliessupporting

confidence: 89%

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Spermicides, hormonal contraception and congenital malformations

Simpson

Phillips

1990

Adv Contracept

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Allegations that inadvertent pregnancies in contraceptive users are associated with congenital anomalies continue to be common. In 1985, a review by one of us concluded that there is little or no scientific basis for such claims [1]. Since then, additional data have substantiated this conclusion, particularly with respect to spermicides and hormonal contraception. The purpose of this review is to update information with respect to potential teratogenicity for these two contraceptive methods.

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Section: Cardiac Anomaliessupporting

confidence: 89%

“…In 1978, Doering and Stewart [2] found 65% of their study population exposed to hormones. A trend toward decreased drug ingestion during pregnancy was delineated for a United States population by Simpson et al [3]. A cohort of 729 women was recruited prior to conception, insulin-dependent diabetics and non-diabetic controls.…”

Section: General Commentsmentioning

confidence: 99%

Spermicides, hormonal contraception and congenital malformations

Simpson

Phillips

1990

Adv Contracept

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“…37 Additional analyses were undertaken with individual items grouped together by organ systems: skull, heart, skeleton, gastrointestinal, and genitourinary. Simple comparisons of continuous outcomes were made using Student's t test or the Wilcoxon rank sum test.…”

Section: Statistical Analysesmentioning

confidence: 99%

The Search for Congenital Malformations in Newborns With Fetal Cocaine Exposure

et al. 2001

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ABSTRACT. Context. The association between prenatal cocaine exposure and congenital anomalies is not definitive.Objective. To determine whether prenatal cocaine exposure results in an increased number or identifiable pattern of abnormalities.Design. A prospective, longitudinal cohort enrolled between 1991 and 1993.Setting. Rural public health population delivering at a regional tertiary medical center.Patients. Two hundred seventy-two offspring of 154 prenatally identified crack/cocaine users and 154 nonusing controls were matched on race, parity, location of prenatal care (that related to level of pregnancy risk), and socioeconomic status. Drug use was determined through repeated in-depth histories and urine screens. Infants not examined within 7 days of birth were excluded.Outcome Measures. Assessments were made by experienced examiners masked to maternal drug history. Included were 16 anthropometric measurements and a checklist of 180 physical features defined and agreed upon in advance.Results. There were no differences on major risk variables between the included and excluded infants. There were significantly more premature infants in the cocaineexposed group. Cocaine-exposed infants were significantly smaller in birth weight, length, and head circumference but did not differ on remaining anthropometric measurements. There was no difference in type or number of abnormalities identified between the exposed and nonexposed groups. There was no relationship between amount or timing of exposure and any of the outcomes.Conclusions. This prospective, large-scale, blinded, systematic evaluation for congenital anomalies in prenatally cocaine-exposed children did not identify an increased number or consistent pattern of abnormalities. A search for congenital malformations related to prenatal cocaine exposure has been underway since physicians became aware of the epidemic of prenatal use in the mid-1980s. Concern has been aroused because of a variety of case reports, small patient series, and retrospective studies reporting abnormalities of the skull, heart, skeleton, gastrointestinal tract, and genitourinary tract in infants born to women who used cocaine during pregnancy. [1][2][3][4][5][6][7][8][9][10][11][12][13] Over the years, the results of prospective studies have yielded somewhat conflicting outcomes. 14 -28 Methodologic concerns in many of these studies have precluded widespread acceptance of their findings, either positive or negative, leaving unanswered the question regarding the association between prenatal cocaine exposure and congenital anomalies.The most commonly identified mechanism of the effects of prenatal exposure involves the vasoconstrictive properties of cocaine. The proper growth and development of the fetus depend on a wellfunctioning vascular system. Vasoconstriction resulting in disruption of blood flow to the fetus could result in the development of structural abnormalities throughout gestation. 29,30 The purpose of this study was to determine whether prenatal cocaine exposure was associat...

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“…As the frequency of exposures is reduced, the recognition of teratogenesis may become impossible by epidemiologic approaches. 91 The epidemiologic investigation of drug teratogenesis presents numerous other difficulties, including multiple use of drugs, the dependence on maternal recall, inadequate concurrent documentation of drug use, and uncertainty regarding timing and dosage. Selected epidemiologic studies of the risk of overall cardiovascular malformations, shown on Table 8, illustrate the inconsistencies in the findings of two casecontrol studies, 92 ' 93 and data on the same agents from the Baltimore-Washington Infant Study.…”

Section: Therapeutic Use Of Drugsmentioning

confidence: 99%

Epidemiology of cardiovascular malformations: The state of the art

Ferencz

Villasenñor

1991

Cardiol Young

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SummaryA historical review highlights an interest in the etiology of birth defects over the course of several centuries and recalls specific hypotheses on the origin of cardiovascular defects postulated 60 years ago. The “State of the Art” of the epidemiology of cardiovascular malformations is characterized by an expanding base of knowledge which holds promise for eventual preventive interventions. Epidemiologic investigations conducted in the past decade have led to an increased understanding of the benefits and problems of studies of populations and of methodologic issues in surveillance of disease and study of risk factors. Comparative evaluations of reported studies to an ongoing population-based case-control investigation (the Baltimore-Washington Infant Study) demonstrate variations in prevalence by time and place, evidence for a strong genetic predisposition to cardiac maldevelopment and new hypotheses regarding environmental risks in the home and place of occupation.

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Drug Ingestion During Pregnancy: Infrequent Exposure in a Contemporary United States Sample

Cited by 10 publications

References 3 publications

Spermicides, hormonal contraception and congenital malformations

Spermicides, hormonal contraception and congenital malformations

The Search for Congenital Malformations in Newborns With Fetal Cocaine Exposure

Epidemiology of cardiovascular malformations: The state of the art

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