title: The distribution of congenital anomalies within the VACTERL association among tumor necrosis factor antagonist-exposed pregnancies is similar to the general population.
abstract: OBJECTIVE
  To compare the distribution of congenital anomalies within the VACTERL association (vertebral defects, anal atresia, cardiac, tracheoesophageal, renal, and limb abnormalities) between patients exposed to tumor necrosis factor-α (TNF-α) antagonist and the general population.
  
  
  METHODS
  Analysis for comparison of proportional differences to a previous publication between anomaly subgroups, according to subgroup definitions of the European Surveillance of Congenital Anomalies (EUROCAT), a population-based database.
  
  
  RESULTS
  Most EUROCAT subgroups belonging to the VACTERL association contained only one or 2 records of TNF-α antagonist exposure, so comparison of proportions was imprecise. Only the category "limb abnormalities" showed a significantly higher proportion in the general population.
  
  
  CONCLUSIONS
  The high number of congenital anomalies belonging to the VACTERL association from a report of pregnancies exposed to TNF-α antagonists could not be confirmed using a population-based congenital anomaly database.
authors: Department of PharmacoEpidemiology and PharmacoEconomics, University of Groningen, Ant Deusinglaan 1, 9713 AV Groningen, The Netherlands.
authors: Hubertina J M J
authors: HJ
authors: Crijns
authors: Janneke
authors: J
authors: Jentink
authors: Ester
authors: E
authors: Garne
authors: Christine C
authors: CC
authors: Gispen-de Wied
authors: Sabine M J M
authors: SM
authors: Straus
authors: Lolkje T W
authors: LT
authors: de Jong-van den Berg
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities; D015331:Cohort Studies; D016208:Databases, Factual; D004947:Esophagus / Q000002:abnormalities; D005060:Europe / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D017880:Limb Deformities, Congenital / Q000139:chemically induced* / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013131:Spine / Q000002:abnormalities; D014132:Trachea / Q000002:abnormalities; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000502:physiology
chemical_list: D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha