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Bendectin and birth defects: I. A meta-analysis of the epidemiologic studies

Authors

  • Paul M. McKeigue,

    1. Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT, England
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  • Dr. Steven H. Lamm,

    Corresponding author
    1. Consultants in Epidemiology and Occupational Health, Inc., Washington, DC 20007
    • Consultants in Epidemiology and Occupational Health, Inc., 2428 Wisconsin Avenue NW, Washington, DC 20007
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  • Shai Linn,

    1. Consultants in Epidemiology and Occupational Health, Inc., Washington, DC 20007
    2. Epidemiology Department, Faculty of Medicine, Rambam Medical Center, Haifa, Israel 31096
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  • Jeffrey S. Kutcher

    1. Consultants in Epidemiology and Occupational Health, Inc., Washington, DC 20007
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Abstract

“Bendectin”11 (Doxylamine/Dicyclomine/Pyridoxine) was widely used for the treatment of nausea and vomiting of pregnancy until 1983, when production was discontinued in the face of lawsuits alleging that the drug caused congenital malformations. We have conducted a meta-analysis of the 16 cohort and 11 case-control studies that report birth defects from Bendectin-exposed pregnancies. This meta-analysis provides an estimate of the relative risk of malformation at birth in association with Bendectin exposure. The pooled estimate of the relative risk of any malformation at birth in association with exposure to Bendectin in the first trimester was 0. 95 (95% Cl 0. 88 to 1. 04). Separate analyses were undertaken for cardiac defects, central nervous system defects, neural tube defects, limb reductions, oral clefts, and genital tract malformations. In these categories, the pooled estimates of relative risk ranged from 0. 81 for oral clefts to 1. 11 for limb reductions, with all 95% confidence intervals enclosing unity. With the exception of studies for oral clefts and for pyloristenosis, tests for heterogeneity of association indicated for each table that all studies were estimating the same odds ratio. These studies, as a group, showed no difference in the risk of birth defects between those infants whose mothers had taken Bendectin during the first trimester of pregnancy and those infants whose mothers had not. It is unlikely that Bendectin exposure contributed to the prevalence of congenital malformations in the population.© 1994 Wiley-Liss, Inc.

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