Shiono P H, Klebanoff M A
National Institute of Child Health and Human Development, Prevention Research Program, Bethesda, Maryland 20892.
Teratology. 1989 Aug;40(2):151-5. doi: 10.1002/tera.1420400208.
The relationship between Bendectin exposure during the first trimester of pregnancy and the occurrence of congenital malformations was prospectively studied in 31,564 newborns registered in the Northern California Kaiser Permanente Birth Defects Study. The odds ratio for any major malformation and Bendectin use was 1.0 (95% confidence interval 0.8-1.4). There were 58 categories of congenital malformations; three of them were statistically associated with Bendectin exposure (microcephaly--odds ratio = 5.3, 95% confidence interval = 1.8-15.6; congenital cataract--odds ratio = 5.3, 95% confidence interval = 1.2-24.3; lung malformations (ICD-8 codes 484.4-484.8)--odds ratio = 4.6, 95% confidence interval = 1.9-10.9). This is exactly the number of associations that would be expected by chance. An independent study (the Collaborative Perinatal Project) was used to determine whether vomiting during pregnancy in the absence of Bendectin use was associated with these three malformations. Two of the three (microcephaly and cataract) had strong positive associations with vomiting in the absence of Bendectin use. We conclude that there is no increase in the overall rate of major malformations after exposure to Bendectin and that the three associations found between Bendectin and individual malformations are unlikely to be causal.
在北加利福尼亚凯撒医疗集团出生缺陷研究中登记的31564名新生儿中,对孕期头三个月接触本迪西汀(Bendectin)与先天性畸形的发生之间的关系进行了前瞻性研究。任何重大畸形与使用本迪西汀的比值比为1.0(95%置信区间0.8 - 1.4)。有58类先天性畸形;其中三类与接触本迪西汀有统计学关联(小头畸形——比值比 = 5.3,95%置信区间 = 1.8 - 15.6;先天性白内障——比值比 = 5.3,95%置信区间 = 1.2 - 24.3;肺部畸形(国际疾病分类第八版编码484.4 - 484.8)——比值比 = 4.6,95%置信区间 = 1.9 - 10.9)。这恰恰是偶然预期会出现的关联数量。一项独立研究(协作围产期项目)被用于确定在未使用本迪西汀的情况下孕期呕吐是否与这三种畸形有关。这三种畸形中的两种(小头畸形和白内障)在未使用本迪西汀的情况下与呕吐有很强的正相关。我们得出结论,接触本迪西汀后主要畸形的总体发生率没有增加,并且本迪西汀与个别畸形之间发现的三种关联不太可能是因果关系。