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Original research article| Volume 51, ISSUE 1, P19-24, January 1995

A changing pattern in the association of oral contraceptives and the different groups of congenital limb deficiencies

  • Andrew E. Czeizel
    Correspondence
    Address for correspondence and reprint requests: Dr. Andrew E. Czeizel, Department of Human Genetics and Teratology, National Institute of Hygiene, 1097 Budapest, Gyáli U. 2-6, Hungary
    Affiliations
    Department of Human Genetics and Teratology, National Institute of Hygiene—WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary
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  • Imre Kodaj
    Affiliations
    Department of Gynecology and Obstetrics, State Hospital, Budapest, Hungary
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      Abstract

      A case-control study on different groups of isolated congenital limb deficiency was performed in a ten-year population-based and revised Hungarian data set. A higher rate of one contraceptive pill type with relatively high dose (ethynodiol diacetate 1.0 mg + ethinyloestradiol 0.05 mg) used in the periconceptional period was found in the mothers of cases with terminal transverse defect (adjusted relative odds 1.9 with 95% confidence interval of 1.1–3.4). This risk is minimised by the use of recent low-dose pills.

      Keywords

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      References

        • Janerich DT
        • Piper JM
        • Glebatis DM
        Oral contraceptives and congenital limb reduction defects.
        N Engl J Med. 1974; 291: 697-700
        • Rothman KJ
        • Louik C
        Oral contraceptives and birth defects.
        N Engl J Med. 1978; 299: 522-524
        • Czeizel A
        • Keller S
        • Bod M
        An aetiological evaluation of increased occurrence of congenital limb reduction abnormalities in Hungary, 1975–1978.
        Int J Epid. 1983; 12: 445-449
        • Kricker A
        • Eliott JW
        • Forrest JM
        • McCredie J
        Congenital limb reduction deformities and use of oral contraceptives.
        Am J Obstet Gynecol. 1986; 155: 1072-1078
        • Heinonen OP
        • Slone D
        • Shapiro S
        Hormones, hormone antagonists and contraceptives.
        in: Heinonen OP Slone D Shapiro S Birth Defects and Drugs in Pregnancy. Littleton M Publ Sciences Group, Littleton, MA1977: 387-400
        • Royal College of General Practitioners
        Oral contraceptive study. The outcome of pregnancy in former oral contraceptive users.
        Br J Obstet Gynaecol. 1976; 83: 606-616
        • Harlap S
        • Shiono PH
        • Ramcharan S
        Congenital abnormalities in the offspring of women who used oral and other contraceptives around the time of conception.
        Int J Fertil. 1985; 30: 39-47
        • Czeizel A
        The activities of the Hungarian Centre for Congenital Anomaly Control.
        WHO Stat Rep Quart. 1988; 41: 219-227
        • Holford TE
        • White C
        • Kelsey JL
        Multivariate analysis for matched case-control studies.
        Am J Epidemiol. 1978; 107: 245-256
      1. Breslow NE, Day WE, Halvorsen KT, et al. Estimation of multiple relative risk functions in matched case-control studies. Am J Epidemiol 197:; 108: 299–307.

        • Czeizel AE
        • Kodaj I
        • Lenz W
        Smoking during pregnancy and congenital limb deficiency.
        Brit Med J. 1994; 308: 1473-1476
        • Czeizel AE
        • Vitez M
        • Kodaj I
        • Lenz W
        An epidemiological study on isolated terminal transverse types of congenital limb deficiency in Hungary, 1975–1984.
        Teratology. 1993; 48: 323-327
        • Bracken MB
        Oral contraception and congenital malformations in offspring: A review and meta-analysis of the prospective studies.
        Obstet Gynecol. 1990; 76: 552-557
        • Wynn V
        Vitamins and oral contraceptive use.
        Lancet. 1975; 1: 561-564
        • Smithells RW
        Oral contraceptives and birth defects.
        Dev Med Child Neurol. 1981; 23B: 69-72
        • Thiersch JB
        Therapeutic abortions with a folic acid antagonist, 4-aminopteroylglutamic acid (4-amino P.G.A.) administered by the oral route.
        Am J Obstet Gynec. 1952; 63: 1298-1304
        • Milunsky A
        • Graet JW
        • Gaynor MFJR
        Methothrexate induced congenital malformations with a review of the literature.
        J Pediatr. 1968; 72: 790-795
        • Elwood JM
        • Little J
        • Elwood JH
        Epidemiology and control of neural tube defects.
        Oxford Medical Publ, Oxford1992
        • Czeizel A
        Are contraceptive pills teratogenic?.
        Acta Morph Acad Sci Hung. 1980; 28: 177-188
        • Hoyme EH
        • Jones KL
        • Van Allen MI
        • et al.
        The vascular pathogenesis of transverse limb reduction defects.
        J Pediatr. 1982; 101: 839-843
        • Harlap S
        • Davies AM
        The pill and births: The Jerusalem study.
        National Institute of Child Health and Human Development, Bethesda, USA1978
        • Mackenzie SG
        • Lippman A
        An investigation of report bias in a case-control study of pregnancy outcome.
        Am J Epidemiol. 1989; 129: 65-75