Postmarketing Analysis of Medicines

There are many surveillance systems of congenital defects all over the world; several of them have developed specific approaches to generate and test selected hypotheses regarding human teratogens. However, to the best of our knowledge, none of them have a permanent and systematised programme for the study of the risk and safety of drugs.The aim of this article is to describe the research programme on the potential effects of drugs in pregnancy followed by the Spanish Collaborative Study of Congenital Malformations (ECEMC), which is a permanent ongoing case-control study and surveillance system. The programme to analyse drugs includes a continuous and systematic study on the potential effects of medicines used during pregnancy. This programme has several characteristics that make it different from other current systems: (i) the collection of numerous datapoints (up to 312 per infant) in a case-control design; (ii) the use of a versatile and specific coding of birth defects; (iii) a specific programme for the continuous analysis of the potential effects of each type of drugs used during pregnancy that has been developed specifically for the ECEMC methodology, including its dysmorphological coding system.The description of the ECEMC’s approach to surveillance of the effects of drug use during pregnancy may help researches in this area, particularly those using data from birth defects registries.

[1]  R. Pfeiffer,et al.  Letters to the EditorTHALIDOMIDE AND CONGENITAL ABNORMALITIES , 1962 .

[2]  O. Mutchinick,et al.  Programa mexicano de "Registro y vigilancia epidemiológica de malformaciones congénitas" , 1988 .

[3]  T. Eskes Congenital malformations worldwide: A report from the International Clearinghouse for Birth Defects Monitoring Systems , 1992 .

[4]  M. Martinez-frias,et al.  Interviewer bias and maternal bias. , 1993, Teratology.

[5]  M V Olson,et al.  The human genome project. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[6]  Engel Lw The Human Genome Project. History, goals, and progress to date. , 1993 .

[7]  M. Martinez-frias,et al.  Epidemiological analysis of the association of congenital diaphragmatic hernia with upper-limb deficiencies: a primary polytopic developmental field defect. , 1996, American journal of medical genetics.

[8]  M. Martinez-frias,et al.  Prenatal exposure to salicylates and gastroschisis: a case-control study. , 1997, Teratology.

[9]  G. Koren,et al.  Safety of first-trimester exposure to topical tretinoin: prospective cohort study , 1997, The Lancet.

[10]  M. Martinez-frias,et al.  Corticosteroids during pregnancy and oral clefts: a case-control study. , 1998, Teratology.

[11]  E. Bermejo,et al.  Prenatal exposure to sex hormones: a case-control study. , 1998, Teratology.

[12]  M. Martinez-frias,et al.  First-trimester exposure to topical tretinoin: its safety is not warranted. , 1999 .

[13]  M. Martinez-frias,et al.  VACTERL as primary, polytopic developmental field defects. , 1999, American journal of medical genetics.

[14]  M. Martinez-frias,et al.  Case-control studies using only malformed infants: are we interpreting the results correctly? , 1999, Teratology.

[15]  Prieto,et al.  Response to 'what kind of controls to use in case control studies of malformed infants: recall bias versus "Teratogen nonspecificity" bias' , 2000, Teratology.

[16]  E. Hook What kind of controls to use in case control studies of malformed infants: recall bias versus "teratogen nonspecificity" bias. , 2000, Teratology.

[17]  E. Bermejo,et al.  Anal atresia, vertebral, genital, and urinary tract anomalies: a primary polytopic developmental field defect identified through an epidemiological analysis of associations. , 2000, American journal of medical genetics.

[18]  M. Martinez-frias,et al.  Case-control studies using only malformed infants who were prenatally exposed to drugs. What do the results mean? , 2000, Teratology.

[19]  E. Bermejo,et al.  Exstrophy of the cloaca and exstrophy of the bladder: two different expressions of a primary developmental field defect. , 2001, American journal of medical genetics.

[20]  M. Martinez-frias,et al.  Epidemiologic analysis of prenatal exposure to cough medicines containing dextromethorphan: no evidence of human teratogenicity. , 2001, Teratology.

[21]  A. Mitchell,et al.  Systematic identification of drugs that cause birth defects--a new opportunity. , 2003, The New England journal of medicine.

[22]  E. Castilla,et al.  ECLAMC: The Latin-American Collaborative Study of Congenital Malformations , 2004, Public Health Genomics.

[23]  M. Martínez‐Frías Segmentation anomalies of the vertebras and ribs: One expression of the primary developmental field , 2004, American journal of medical genetics. Part A.

[24]  J. Salvador,et al.  Epidemiological aspects of prenatal exposure to high doses of vitamin a in Spain , 1990, European Journal of Epidemiology.

[25]  A. Czeizel,et al.  A population‐based case–control study of oral griseofulvin treatment during pregnancy , 2004, Acta Obstetricia et Gynecologica Scandinavica.

[26]  B. Källén,et al.  An international case-control study on hypospadias the problem with variability and the beauty of diversity , 1992, European Journal of Epidemiology.

[27]  A. Rimm,et al.  A Meta-Analysis of Controlled Studies Comparing Major Malformation Rates in IVF and ICSI Infants with Naturally Conceived Children , 2004, Journal of Assisted Reproduction and Genetics.

[28]  B. Källén,et al.  Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation‐wide, population‐based register study , 2004, Acta paediatrica.

[29]  E. Bermejo,et al.  Evolución secular y por autonomías de la frecuencia de tratamientos de fertilidad, partos múltiples y cesáreas en España , 2005 .

[30]  J. Emberson,et al.  A multi-centre cohort study of the physical health of 5-year-old children conceived after intracytoplasmic sperm injection, in vitro fertilization and natural conception. , 2005, Human reproduction.

[31]  P. Little Structure and function of the human genome. , 2005, Genome research.