Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study
In Europe, the prevalence of congenital ocular anomaly (COA) is estimated at 3.7 per 10,000 births. While certain COAs have a genetic origin, the cause for most patients remains unknown. The role of medications administered during pregnancy in COA genesis in humans is unclear. To investigate any ass...
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creator | Cifuentes, E-A Beau, A Caillet, A Frémont, F Neville, A J Ballardini, E Dolk, H Loane, M Garne, E Khoshnood, B Lelong, N Rissmann, A O'Mahony, M Pierini, A Gatt, M Bergman, J E H Krawczynski, M R Latos Bielenska, A Echevarría González de Garibay, L-J Cavero Carbonell, C Addor, M-C Tucker, D Jordan, S Den Hond, E Nelen, V Barisic, I Rouget, F Randrianaivo, H Hoareau, J Perthus, I Courtade-Saïdi, M Damase-Michel, C Dubucs, C |
description | In Europe, the prevalence of congenital ocular anomaly (COA) is estimated at 3.7 per 10,000 births. While certain COAs have a genetic origin, the cause for most patients remains unknown. The role of medications administered during pregnancy in COA genesis in humans is unclear.
To investigate any association between fetal exposure in the first trimester of pregnancy to medications and the occurrence of COA.
We conducted a case-malformed-control study using data on 298,351 cases registered as having congenital anomalies (CA) from 19 registries and one healthcare database in 13 European countries. Two analyses were performed: (i) A signal confirmation analysis of signals from the literature, examining associations between COA and specific medications (nitrofurantoin, NSAIDs, opioids, alprazolam, antihypertensives, asthma medications, pyridoxine, and hydroxyethylrutoside). (ii) A signal detection analysis of all medications reported in the database.
We identified 4185 COA cases and 232,718 nongenetic and 38,409 genetic controls. We confirmed the association between prenatal opioid exposure and COA (aROR: 2.66, 95% CI: 1.18, 6.02, and 3.22, 95% CI: 1.35, 7.69, for nongenetic and genetic controls, respectively). Signal detection analysis revealed consistent associations for antiglaucoma preparations and miotics (p |
doi_str_mv | 10.1002/bdr2.2435 |
format | Article |
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To investigate any association between fetal exposure in the first trimester of pregnancy to medications and the occurrence of COA.
We conducted a case-malformed-control study using data on 298,351 cases registered as having congenital anomalies (CA) from 19 registries and one healthcare database in 13 European countries. Two analyses were performed: (i) A signal confirmation analysis of signals from the literature, examining associations between COA and specific medications (nitrofurantoin, NSAIDs, opioids, alprazolam, antihypertensives, asthma medications, pyridoxine, and hydroxyethylrutoside). (ii) A signal detection analysis of all medications reported in the database.
We identified 4185 COA cases and 232,718 nongenetic and 38,409 genetic controls. We confirmed the association between prenatal opioid exposure and COA (aROR: 2.66, 95% CI: 1.18, 6.02, and 3.22, 95% CI: 1.35, 7.69, for nongenetic and genetic controls, respectively). Signal detection analysis revealed consistent associations for antiglaucoma preparations and miotics (p < 0.01) related to COA. Other associations included congenital cataracts and lens anomalies with desloratadine, congenital glaucoma with antiepileptics, and eyelid malformations with dermatological hydrocortisone.
This pharmacoepidemiological study in Europe analyzing COA following fetal medication exposure confirmed reported signals regarding opioids and COA and identified new associations. Validation in independent datasets is necessary to consolidate these findings.</description><identifier>ISSN: 2472-1727</identifier><identifier>EISSN: 2472-1727</identifier><identifier>DOI: 10.1002/bdr2.2435</identifier><identifier>PMID: 39890450</identifier><language>eng</language><publisher>United States: Wiley</publisher><subject>Abnormalities, Drug-Induced - epidemiology ; Adult ; Case-Control Studies ; Europe ; Eye Abnormalities - chemically induced ; Eye Abnormalities - epidemiology ; Eye Abnormalities - genetics ; Female ; Humans ; Life Sciences ; Male ; Maternal Exposure - adverse effects ; Pregnancy ; Pregnancy Trimester, First ; Prenatal Exposure Delayed Effects - chemically induced ; Registries ; Risk Factors</subject><ispartof>Birth defects research, 2025-02, Vol.117 (2), p.e2435</ispartof><rights>2025 Wiley Periodicals LLC.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1240-97979da7f5c9a5e5b624ff8ac152ab16a0ce8980d98b4be5e46d00e92686bf453</cites><orcidid>0000-0003-2371-4113 ; 0000-0001-6639-5904 ; 0000-0002-9437-2790 ; 0000-0002-3929-3619 ; 0000-0002-1206-3637 ; 0000-0003-3077-5918 ; 0000-0003-3321-9343 ; 0000-0003-1557-9919 ; 0000-0002-5691-2987 ; 0000-0003-4631-100X ; 0000-0002-4268-7707 ; 0000-0002-8813-1835 ; 0000-0002-9085-6747 ; 0000-0001-5514-0893 ; 0000-0002-4031-4915 ; 0000-0002-4858-6456 ; 0000-0002-3845-6180 ; 0000-0002-0884-4131 ; 0000-0003-3299-1083 ; 0000-0001-5018-0108</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39890450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-04928756$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Cifuentes, E-A</creatorcontrib><creatorcontrib>Beau, A</creatorcontrib><creatorcontrib>Caillet, A</creatorcontrib><creatorcontrib>Frémont, F</creatorcontrib><creatorcontrib>Neville, A J</creatorcontrib><creatorcontrib>Ballardini, E</creatorcontrib><creatorcontrib>Dolk, H</creatorcontrib><creatorcontrib>Loane, M</creatorcontrib><creatorcontrib>Garne, E</creatorcontrib><creatorcontrib>Khoshnood, B</creatorcontrib><creatorcontrib>Lelong, N</creatorcontrib><creatorcontrib>Rissmann, A</creatorcontrib><creatorcontrib>O'Mahony, M</creatorcontrib><creatorcontrib>Pierini, A</creatorcontrib><creatorcontrib>Gatt, M</creatorcontrib><creatorcontrib>Bergman, J E H</creatorcontrib><creatorcontrib>Krawczynski, M R</creatorcontrib><creatorcontrib>Latos Bielenska, A</creatorcontrib><creatorcontrib>Echevarría González de Garibay, L-J</creatorcontrib><creatorcontrib>Cavero Carbonell, C</creatorcontrib><creatorcontrib>Addor, M-C</creatorcontrib><creatorcontrib>Tucker, D</creatorcontrib><creatorcontrib>Jordan, S</creatorcontrib><creatorcontrib>Den Hond, E</creatorcontrib><creatorcontrib>Nelen, V</creatorcontrib><creatorcontrib>Barisic, I</creatorcontrib><creatorcontrib>Rouget, F</creatorcontrib><creatorcontrib>Randrianaivo, H</creatorcontrib><creatorcontrib>Hoareau, J</creatorcontrib><creatorcontrib>Perthus, I</creatorcontrib><creatorcontrib>Courtade-Saïdi, M</creatorcontrib><creatorcontrib>Damase-Michel, C</creatorcontrib><creatorcontrib>Dubucs, C</creatorcontrib><title>Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study</title><title>Birth defects research</title><addtitle>Birth Defects Res</addtitle><description>In Europe, the prevalence of congenital ocular anomaly (COA) is estimated at 3.7 per 10,000 births. While certain COAs have a genetic origin, the cause for most patients remains unknown. The role of medications administered during pregnancy in COA genesis in humans is unclear.
To investigate any association between fetal exposure in the first trimester of pregnancy to medications and the occurrence of COA.
We conducted a case-malformed-control study using data on 298,351 cases registered as having congenital anomalies (CA) from 19 registries and one healthcare database in 13 European countries. Two analyses were performed: (i) A signal confirmation analysis of signals from the literature, examining associations between COA and specific medications (nitrofurantoin, NSAIDs, opioids, alprazolam, antihypertensives, asthma medications, pyridoxine, and hydroxyethylrutoside). (ii) A signal detection analysis of all medications reported in the database.
We identified 4185 COA cases and 232,718 nongenetic and 38,409 genetic controls. We confirmed the association between prenatal opioid exposure and COA (aROR: 2.66, 95% CI: 1.18, 6.02, and 3.22, 95% CI: 1.35, 7.69, for nongenetic and genetic controls, respectively). Signal detection analysis revealed consistent associations for antiglaucoma preparations and miotics (p < 0.01) related to COA. Other associations included congenital cataracts and lens anomalies with desloratadine, congenital glaucoma with antiepileptics, and eyelid malformations with dermatological hydrocortisone.
This pharmacoepidemiological study in Europe analyzing COA following fetal medication exposure confirmed reported signals regarding opioids and COA and identified new associations. Validation in independent datasets is necessary to consolidate these findings.</description><subject>Abnormalities, Drug-Induced - epidemiology</subject><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Europe</subject><subject>Eye Abnormalities - chemically induced</subject><subject>Eye Abnormalities - epidemiology</subject><subject>Eye Abnormalities - genetics</subject><subject>Female</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Maternal Exposure - adverse effects</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>Prenatal Exposure Delayed Effects - chemically induced</subject><subject>Registries</subject><subject>Risk Factors</subject><issn>2472-1727</issn><issn>2472-1727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkMtOwzAQRS0EolXpgh9AXsIixXb8CruoKhSpqKi0S2Q5iQOBJC52gujfk6jloVnM6M7RXRwAzjGaYITIdZI5MiE0ZEdgSKggARZEHP-7B2Ds_RtCCEuCRShPwSCMZIQoQ0PwvCr8O7Q5nNr6xdRFo0u4TNtSOxjXttLlDsZ5Yxx8dKbW_Xf2tbW-dQY2Fj6YrEh1U9ja38AYzjarZdVF03gNn5o2252Bk1yX3owPewQ2t7P1dB4slnf303gRpJhQFESim0yLnKWRZoYlnNA8lzrFjOgEc41SIyOJskgmNDHMUJ4hZCLCJU9yysIRuNr3vupSbV1RabdTVhdqHi9UnyEaESkY_8Qde7lnt85-tMY3qip8aspS18a2XoWYEyYIZ_yvNnXWe2fy326MVC9f9fJVL79jLw61bdI5-CV_VIffWSB9AA</recordid><startdate>202502</startdate><enddate>202502</enddate><creator>Cifuentes, E-A</creator><creator>Beau, A</creator><creator>Caillet, A</creator><creator>Frémont, F</creator><creator>Neville, A J</creator><creator>Ballardini, E</creator><creator>Dolk, H</creator><creator>Loane, M</creator><creator>Garne, E</creator><creator>Khoshnood, B</creator><creator>Lelong, N</creator><creator>Rissmann, A</creator><creator>O'Mahony, M</creator><creator>Pierini, A</creator><creator>Gatt, M</creator><creator>Bergman, J E H</creator><creator>Krawczynski, M R</creator><creator>Latos Bielenska, A</creator><creator>Echevarría González de Garibay, L-J</creator><creator>Cavero Carbonell, C</creator><creator>Addor, M-C</creator><creator>Tucker, D</creator><creator>Jordan, S</creator><creator>Den Hond, E</creator><creator>Nelen, V</creator><creator>Barisic, I</creator><creator>Rouget, F</creator><creator>Randrianaivo, H</creator><creator>Hoareau, J</creator><creator>Perthus, I</creator><creator>Courtade-Saïdi, M</creator><creator>Damase-Michel, C</creator><creator>Dubucs, C</creator><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-2371-4113</orcidid><orcidid>https://orcid.org/0000-0001-6639-5904</orcidid><orcidid>https://orcid.org/0000-0002-9437-2790</orcidid><orcidid>https://orcid.org/0000-0002-3929-3619</orcidid><orcidid>https://orcid.org/0000-0002-1206-3637</orcidid><orcidid>https://orcid.org/0000-0003-3077-5918</orcidid><orcidid>https://orcid.org/0000-0003-3321-9343</orcidid><orcidid>https://orcid.org/0000-0003-1557-9919</orcidid><orcidid>https://orcid.org/0000-0002-5691-2987</orcidid><orcidid>https://orcid.org/0000-0003-4631-100X</orcidid><orcidid>https://orcid.org/0000-0002-4268-7707</orcidid><orcidid>https://orcid.org/0000-0002-8813-1835</orcidid><orcidid>https://orcid.org/0000-0002-9085-6747</orcidid><orcidid>https://orcid.org/0000-0001-5514-0893</orcidid><orcidid>https://orcid.org/0000-0002-4031-4915</orcidid><orcidid>https://orcid.org/0000-0002-4858-6456</orcidid><orcidid>https://orcid.org/0000-0002-3845-6180</orcidid><orcidid>https://orcid.org/0000-0002-0884-4131</orcidid><orcidid>https://orcid.org/0000-0003-3299-1083</orcidid><orcidid>https://orcid.org/0000-0001-5018-0108</orcidid></search><sort><creationdate>202502</creationdate><title>Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study</title><author>Cifuentes, E-A ; Beau, A ; Caillet, A ; Frémont, F ; Neville, A J ; Ballardini, E ; Dolk, H ; Loane, M ; Garne, E ; Khoshnood, B ; Lelong, N ; Rissmann, A ; O'Mahony, M ; Pierini, A ; Gatt, M ; Bergman, J E H ; Krawczynski, M R ; Latos Bielenska, A ; Echevarría González de Garibay, L-J ; Cavero Carbonell, C ; Addor, M-C ; Tucker, D ; Jordan, S ; Den Hond, E ; Nelen, V ; Barisic, I ; Rouget, F ; Randrianaivo, H ; Hoareau, J ; Perthus, I ; Courtade-Saïdi, M ; Damase-Michel, C ; Dubucs, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1240-97979da7f5c9a5e5b624ff8ac152ab16a0ce8980d98b4be5e46d00e92686bf453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Abnormalities, Drug-Induced - epidemiology</topic><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Europe</topic><topic>Eye Abnormalities - chemically induced</topic><topic>Eye Abnormalities - epidemiology</topic><topic>Eye Abnormalities - genetics</topic><topic>Female</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Maternal Exposure - adverse effects</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>Prenatal Exposure Delayed Effects - chemically induced</topic><topic>Registries</topic><topic>Risk Factors</topic><toplevel>online_resources</toplevel><creatorcontrib>Cifuentes, E-A</creatorcontrib><creatorcontrib>Beau, A</creatorcontrib><creatorcontrib>Caillet, A</creatorcontrib><creatorcontrib>Frémont, F</creatorcontrib><creatorcontrib>Neville, A J</creatorcontrib><creatorcontrib>Ballardini, E</creatorcontrib><creatorcontrib>Dolk, H</creatorcontrib><creatorcontrib>Loane, M</creatorcontrib><creatorcontrib>Garne, E</creatorcontrib><creatorcontrib>Khoshnood, B</creatorcontrib><creatorcontrib>Lelong, N</creatorcontrib><creatorcontrib>Rissmann, A</creatorcontrib><creatorcontrib>O'Mahony, M</creatorcontrib><creatorcontrib>Pierini, A</creatorcontrib><creatorcontrib>Gatt, M</creatorcontrib><creatorcontrib>Bergman, J E H</creatorcontrib><creatorcontrib>Krawczynski, M R</creatorcontrib><creatorcontrib>Latos Bielenska, A</creatorcontrib><creatorcontrib>Echevarría González de Garibay, L-J</creatorcontrib><creatorcontrib>Cavero Carbonell, C</creatorcontrib><creatorcontrib>Addor, M-C</creatorcontrib><creatorcontrib>Tucker, D</creatorcontrib><creatorcontrib>Jordan, S</creatorcontrib><creatorcontrib>Den Hond, E</creatorcontrib><creatorcontrib>Nelen, V</creatorcontrib><creatorcontrib>Barisic, I</creatorcontrib><creatorcontrib>Rouget, F</creatorcontrib><creatorcontrib>Randrianaivo, H</creatorcontrib><creatorcontrib>Hoareau, J</creatorcontrib><creatorcontrib>Perthus, I</creatorcontrib><creatorcontrib>Courtade-Saïdi, M</creatorcontrib><creatorcontrib>Damase-Michel, C</creatorcontrib><creatorcontrib>Dubucs, C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Birth defects research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cifuentes, E-A</au><au>Beau, A</au><au>Caillet, A</au><au>Frémont, F</au><au>Neville, A J</au><au>Ballardini, E</au><au>Dolk, H</au><au>Loane, M</au><au>Garne, E</au><au>Khoshnood, B</au><au>Lelong, N</au><au>Rissmann, A</au><au>O'Mahony, M</au><au>Pierini, A</au><au>Gatt, M</au><au>Bergman, J E H</au><au>Krawczynski, M R</au><au>Latos Bielenska, A</au><au>Echevarría González de Garibay, L-J</au><au>Cavero Carbonell, C</au><au>Addor, M-C</au><au>Tucker, D</au><au>Jordan, S</au><au>Den Hond, E</au><au>Nelen, V</au><au>Barisic, I</au><au>Rouget, F</au><au>Randrianaivo, H</au><au>Hoareau, J</au><au>Perthus, I</au><au>Courtade-Saïdi, M</au><au>Damase-Michel, C</au><au>Dubucs, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study</atitle><jtitle>Birth defects research</jtitle><addtitle>Birth Defects Res</addtitle><date>2025-02</date><risdate>2025</risdate><volume>117</volume><issue>2</issue><spage>e2435</spage><pages>e2435-</pages><issn>2472-1727</issn><eissn>2472-1727</eissn><abstract>In Europe, the prevalence of congenital ocular anomaly (COA) is estimated at 3.7 per 10,000 births. While certain COAs have a genetic origin, the cause for most patients remains unknown. The role of medications administered during pregnancy in COA genesis in humans is unclear.
To investigate any association between fetal exposure in the first trimester of pregnancy to medications and the occurrence of COA.
We conducted a case-malformed-control study using data on 298,351 cases registered as having congenital anomalies (CA) from 19 registries and one healthcare database in 13 European countries. Two analyses were performed: (i) A signal confirmation analysis of signals from the literature, examining associations between COA and specific medications (nitrofurantoin, NSAIDs, opioids, alprazolam, antihypertensives, asthma medications, pyridoxine, and hydroxyethylrutoside). (ii) A signal detection analysis of all medications reported in the database.
We identified 4185 COA cases and 232,718 nongenetic and 38,409 genetic controls. We confirmed the association between prenatal opioid exposure and COA (aROR: 2.66, 95% CI: 1.18, 6.02, and 3.22, 95% CI: 1.35, 7.69, for nongenetic and genetic controls, respectively). Signal detection analysis revealed consistent associations for antiglaucoma preparations and miotics (p < 0.01) related to COA. Other associations included congenital cataracts and lens anomalies with desloratadine, congenital glaucoma with antiepileptics, and eyelid malformations with dermatological hydrocortisone.
This pharmacoepidemiological study in Europe analyzing COA following fetal medication exposure confirmed reported signals regarding opioids and COA and identified new associations. Validation in independent datasets is necessary to consolidate these findings.</abstract><cop>United States</cop><pub>Wiley</pub><pmid>39890450</pmid><doi>10.1002/bdr2.2435</doi><orcidid>https://orcid.org/0000-0003-2371-4113</orcidid><orcidid>https://orcid.org/0000-0001-6639-5904</orcidid><orcidid>https://orcid.org/0000-0002-9437-2790</orcidid><orcidid>https://orcid.org/0000-0002-3929-3619</orcidid><orcidid>https://orcid.org/0000-0002-1206-3637</orcidid><orcidid>https://orcid.org/0000-0003-3077-5918</orcidid><orcidid>https://orcid.org/0000-0003-3321-9343</orcidid><orcidid>https://orcid.org/0000-0003-1557-9919</orcidid><orcidid>https://orcid.org/0000-0002-5691-2987</orcidid><orcidid>https://orcid.org/0000-0003-4631-100X</orcidid><orcidid>https://orcid.org/0000-0002-4268-7707</orcidid><orcidid>https://orcid.org/0000-0002-8813-1835</orcidid><orcidid>https://orcid.org/0000-0002-9085-6747</orcidid><orcidid>https://orcid.org/0000-0001-5514-0893</orcidid><orcidid>https://orcid.org/0000-0002-4031-4915</orcidid><orcidid>https://orcid.org/0000-0002-4858-6456</orcidid><orcidid>https://orcid.org/0000-0002-3845-6180</orcidid><orcidid>https://orcid.org/0000-0002-0884-4131</orcidid><orcidid>https://orcid.org/0000-0003-3299-1083</orcidid><orcidid>https://orcid.org/0000-0001-5018-0108</orcidid></addata></record> |
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recordid | cdi_hal_primary_oai_HAL_hal_04928756v1 |
source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
subjects | Abnormalities, Drug-Induced - epidemiology Adult Case-Control Studies Europe Eye Abnormalities - chemically induced Eye Abnormalities - epidemiology Eye Abnormalities - genetics Female Humans Life Sciences Male Maternal Exposure - adverse effects Pregnancy Pregnancy Trimester, First Prenatal Exposure Delayed Effects - chemically induced Registries Risk Factors |
title | Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-16T09%3A55%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20Congenital%20Ocular%20Anomaly%20After%20Prenatal%20Exposure%20to%20Medications:%20A%20EUROmediCAT%20Study&rft.jtitle=Birth%20defects%20research&rft.au=Cifuentes,%20E-A&rft.date=2025-02&rft.volume=117&rft.issue=2&rft.spage=e2435&rft.pages=e2435-&rft.issn=2472-1727&rft.eissn=2472-1727&rft_id=info:doi/10.1002/bdr2.2435&rft_dat=%3Cproquest_hal_p%3E3162572656%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3162572656&rft_id=info:pmid/39890450&rfr_iscdi=true |