Meclizine in pregnancy in relation to congenital malformations.
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Biomedical subjects
Publications and source records attributed to D W Kaufman.
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In a prospective cohort study of 20, 282 gravidas and their offspring, congenital malformation rates were similar in the children of over 1,000 women exposed and those not exposed to two components of Bendectin (doxylamine succinate and dicyclomine hydrochloride) during the first four lunar months of pregnancy. In a cohort reduced to 41,337 mother-child pairs for technical reasons, mean birth weight and perinatal mortality rates were similar according to exposure or nonexposure to either drug, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter these findings.
In a prospective cohort study of 50,282 gravidas and their offspring, over-all rates of congenital malformations were similar in 1,309 children of women exposed to phenothiazine drugs during the first four lunar months of pregnancy and in 48,973 children of women who were not exposed. There was a suspicion of association between phenothiazine exposure and cardiovascular malformations. In a cohort reduced to 41,337 mother-child pairs for technical reasons, perinatal mortality rates and mean birth weight were similar according to phenothiazine exposure or nonexposure, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter the findings.
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.
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.
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The pulmonate land snail Rumina decollata in its native Mediterranean range is a complex of monogenic or weakly polygenic strains generated by a breeding system of facultative self-fertilization. One strain colonized North America and now occupies much of the southern United States and northern Mexico. No genetic variation within or among populations in the United States was detected in an electrophoretic analysis of proteins encoded by 25 loci. These findings emphasize the potential for adaptive convergence in the genetic systems of hermaphroditic animals and plants.
Levels of genic heterozygosity, as measured by surveys of allozymic variation, are much lower in populations of large, mobile animals (most vertebrates) than in those of small, relatively immobile animals (most invertebrates). This difference is not consistent with theories relating variability to population size (species number) or dispersal ability (gene flow), but it is predicted by Levins' theory of adaptive strategies in relation to environmental uncertainty ("grain"). Mobility and degree of homeostatic control apparently are important factors influencing levels of genic heterozygosity in natural populations. The results argue indirectly that at least a major proportion of allozymic variation is maintained by natural selection.
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The modifying influence of individual risk factors on the relation between myocardial infarction (MI) and cigarette smoking was evaluated in a case-control study of women younger than 50 years of age. Data from 555 women who survived first MIs were compared with those of 1,864 hospital controls of similar ages. The risk of MI increased with the number of cigarettes smoked, both in the presence and absence of factors that predispose to an infarction. In particular, the association was apparent at all ages, at all levels of total serum cholesterol and high-density lipoprotein cholesterol, and in the presence and absence of oral contraceptive use, hypertension, diabetes mellitus, blood group A, tendency to type A behavior, and family history of MI. The relative increase in risk was generally greater the lower the underlying predisposition to MI. There was clear evidence, however, that recent oral contraceptive use substantially augmented the increased risk for smokers, and hypercholesterolemia may have had the same effect.