Hill L, Murphy M, McDowall M, Paul A H
Medicines Division, DHSS, London.
J Epidemiol Community Health. 1988 Mar;42(1):1-7. doi: 10.1136/jech.42.1.1.
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.
在一项病例对照研究中，对以下三组人群末次月经前三个月以及孕期头三个月的处方数据进行了检查：(a) 115名生育肢体短小缺陷患儿的母亲；(b) 676名生育唇腭裂患儿的母亲；(c) 来自同一医生诊所的、数量与上述两组病例母亲相等的正常婴儿母亲作为对照。在肢体短小缺陷研究中，尽管研究组母亲总体上所开药物更多，但未达到统计学显著差异，且研究组与对照组母亲在各类药物的使用上也无显著差异。在唇腭裂研究中，末次月经前三个月研究组母亲所开药物显著更多，孕期头三个月也观察到类似趋势，但未达到统计学显著差异。在整个研究期间，研究组母亲使用抗惊厥药物的频率显著更高。末次月经前三个月服用口服避孕药与唇腭裂之间也显示出显著关联，但这种关系仍存在疑问；其风险尚未完全明确，可能是非特异性的。还发现了一些其他显著关联，不过鉴于此类研究可能存在的混杂因素，它们在实际中的重要性尚不确定。
