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Biomedical subjects

D Slone

Publications and source records attributed to D Slone.

25 records · Page 2Linked to original sources

Aspirin and congenital malformations.

In a cohort of 50 282 gravidas and their offspring in the U.S.A., malformation rates were similar in the children of 35 418 women not exposed to aspirin, 9736 with intermediate exposure, and 5128 women heavily exposed during the first four lunar months of pregnancy. After controlling a wide range of potential confounding factors using multi-variate analysis, the observed and expected numbers for a variety of malformation categories were similar in all three comparison groups. The data suggest that aspirin is not teratogenic.

Abnormalities, Drug-Induced

Perinatal mortality and birth-weight in relation to aspirin taken during pregnancy.

In a cohort of 41 337 gravidas and their offspring in the U.S.A. there was no evidence that aspirin taken in pregnancy is a cause of stillbirth, neonatal death, or reduced birth-weight. The women were divided into those who were not exposed to aspirin (14 956), those with intermediate exposure (24 866), and those who were heavily exposed (1515). Stillbirth-rates were similar for all three groups. Differences in neonatal death-rates and mean birth-weights were slight and none were statistically significant. Trends were opposite among approximately equal numbers of White and Black children.

Aspirin

Anticonvulsants and parental epilepsy in the development of birth defects.

The results of two studies, one in Finland and one in the U.S.A., raise the possibility that fetal damage previously attributed to phenytoin and other anticonvulsant drugs, principally phenobarbitone, may be due to epilepsy itself. In the U.S.A., drug-exposure information was collected before delivery in a cohort of 50 282 mother/child pairs. The total malformation rate in 305 children born to epileptic mothers was 10.5%, as against 6.4% in the remainder (p less than 0.01); corresponding rates for major malformations were 6.6% and 2.7%. When the fathers had epilepsy, the malformation-rates in their children were intermediate. The rates did not vary significantly according to maternal anticonvulsants therapy. Mental and motor scores as 8 months of age, and intelligence quotient scores at 4 years were lower in children of epileptic mothers, but not in children of epileptic fathers. The scores showed only random variation according to maternal anticonvulsant therapy. In Finland, 2784 children with craniofacial anomalies were compared with an equal number of normal children; 8 and 2 mothers, respectively, received anticonvulsants, while pregnant, for epilepsy. In that study, the separate effects of the disease and its treatmet could not be evaluated. Both studies did not find evidence of fetal damage when phenobarbitone was taken for indications other than epilepsy.

Abnormalities, Drug-Induced

Use of antimicrobial drugs in medical wards.

Antimicrobial usage patterns in 17,750 consecutive medical in-patients, monitored between 1966 and 1972 are described. 36.4% of all patients were exposed to one or more antimicrobials and about half of them received more than one antimicrobial agent. Penicillins accounted for 49% of all exposures and use of ampicillin rose steadily over the years. Concomitant receipt of more than one antimicrobial was common (22% of all exposed patients). Of 171 possible two-drug combinations involving 19 drugs, 126 were actually encountered. Apart from combinations, 60% of antimicrobial recipients received more than one agent at different times.

Anti-Infective Agents

Antenatal exposure to meprobamate and chlordiazepoxide in relation to malformations, mental development, and childhood mortality.

In a follow-up study of 50,282 pregnancies (lasting at least five lunar months) and the offspring, malformations identified before the first birthday, or at death before the fourth birthday, were identified in 3248 children (6.5 per cent). A total of 1870 children exposed in utero to meprobamate or chlordiazepoxide were compared with 48,412 children who were not. No significant differences were found either overall or in specific outcomes; rates were also similar when exposures occurred during the first trimester or at other times during pregnancy. Deaths (stillbirth to the fourth birthday) occurred in 2227 children (4.4 per cent), and there was no evidence that antenatal exposure to either drug increased the death rate. Finally, as judged by mental and motor scores at the age of eight months, and intelligence quotient scores at four years, there was no evidence that the drugs cause brain damage.

Abnormalities, Drug-Induced