title: Spontaneous abortion and a diet drug containing caffeine and ephedrine: a study within the Danish national birth cohort.
abstract: BACKGROUND
  Medications may be consumed periconceptionally before a woman knows she is pregnant. In this study, the authors evaluate the association of a prescription diet drug (Letigen) containing ephedrine (20 mg) and caffeine (200 mg) with spontaneous abortion (SAB) in the Danish National Birth Cohort.
  
  
  METHODS
  Women were recruited during their first prenatal visit from 1996-2002. Pre-conception and early pregnancy medication use was reported on the enrollment form, and pregnancy outcome was determined by linking the mother's Civil Registration Number to the Medical Birth Registry and the National Hospital Discharge Register. Of 97,903 eligible pregnancies, 4,443 ended in SAB between 5 and 20 completed gestational weeks, inclusive. Letigen use was reported for 565 pregnancies. Cox regression models accounting for left truncation were fit to estimate the effect of pre-conception and early pregnancy Letigen use on SAB.
  
  
  RESULTS
  The estimated maternal age-adjusted hazard ratio for SAB was 1.1 (95% confidence interval 0.8-1.6) for any periconceptional Letigen use compared to no periconceptional use.
  
  
  CONCLUSIONS
  Although Letigen has high levels of caffeine (the recommended 3 pills/day are approximately equivalent to caffeine from 6 cups of coffee), periconceptional use does not appear to be associated with an appreciably increased hazard of clinically recognized SAB.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America. penelope.howards@emory.edu
authors.forename: Penelope P
authors.initials: PP
authors.lastname: Howards
authors.forename: Irva
authors.initials: I
authors.lastname: Hertz-Picciotto
authors.forename: Bodil H
authors.initials: BH
authors.lastname: Bech
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Nohr
authors.forename: Anne-Marie Nybo
authors.initials: AM
authors.lastname: Andersen
authors.forename: Charles
authors.initials: C
authors.lastname: Poole
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced* / Q000453:epidemiology*; D019440:Anti-Obesity Agents / Q000009:adverse effects*; D002110:Caffeine / Q000009:adverse effects*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004338:Drug Combinations; D004809:Ephedrine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011247:Pregnancy; D016016:Proportional Hazards Models; D012044:Regression Analysis
chemical_list: D019440:Anti-Obesity Agents; D004338:Drug Combinations; C029944:caffeine, ephedrine drug combination; D002110:Caffeine; D004809:Ephedrine