Bengt Källén Knihy

Combining existing literature on maternal drug use and birth defects with new data, this book offers a comprehensive analysis of the effects of various drugs during pregnancy. It explores the relationship between drug exposure and developmental outcomes, providing valuable insights for healthcare professionals and expectant mothers. The synthesis of established research and fresh findings aims to enhance understanding and inform safer practices regarding medication use in pregnancy.

Authored by Bengt Källén, professor emeritus in embryology at Lund University in Sweden. ​​The subject of this book is to describe the occurrence of congenital malformations among children born and what risk factors exist. Population data are presented for a number of malformations, ascertained with the use of data from the Swedish national health registers for the period 1998-2010 corresponding to some 1.3 million births, together with prospectively collected information on a group of exposures of possible interest. The structure of the analysis is such that it excludes studies of, for instance, nutrition, alcohol or street drug use and many other lifestyle factors where prospective information or independent register information is difficult or impossible to obtain. Epidemiology of Human Congenital Malformations culminates with a discussion on how the presence of malformations can be explained and various possibilities for the prevention of birth defects. Moreover, it will include a series of instructions on how to read epidemiological literature in this field making it an essential resource both for those currently working in the field of reproductive epidemiology or those intending to enter it. It will additionally be useful for doctors working with malformations, either as obstetricians, neonatologists or pediatricians.

This book addresses methodological aspects of epidemiological studies on maternal drug use in pregnancy. Discussing the existing sources of error and how they can produce incorrect conclusions, it examines various epidemiological techniques and assesses their strengths and weaknesses. These refer both to the identification of outcomes (with special emphasis on congenital malformations) and to the types of exposure (drug use). Further, the book discusses the problem of confounding and how to handle it, and provides a simple introduction to statistics. Special situations, e.g. different types of parental exposure, are examined. Lastly, the book discusses pharmacovigilance and the information problem, concluding with a short list of aspects to consider when one wants to evaluate a published paper in the field. Though the book is primarily intended for pharmacologists, gynecologists and obstetricians, it will benefit all doctors working in perinatal care.