{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:08:44Z","timestamp":1791889724953,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,1,10]],"date-time":"2007-01-10T00:00:00Z","timestamp":1168387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND<\/jats:bold>: Maternal exposure to flu or fever has been associated with increased risk for neural tube defects (NTDs); however, few studies have considered the effects of medications on the effects of flu or fever. We evaluated the effect of maternal flu or fever, medication use (antibiotics, antipyretics), and their joint effect on NTDs. <jats:bold>METHODS<\/jats:bold>: Data came from an ongoing population\u2010based case\u2010control study of infants with external malformations in northern China. The case group included 363 infants with NTDs identified between January 2003 and June 2005. Controls were 523 newborn infants without identified congenital anomalies matched by county, sex, maternal ethnic group, and the closest date of conception for infants with any major external malformation. Data were collected by a trained health worker through face\u2010to\u2010face interviews after delivery. <jats:bold>RESULTS<\/jats:bold>: NTD risks were significantly associated with maternal flu or fever (adjusted odds ratio [AOR] = 3.93, 95% CI: 2.48\u20136.23) and antipyretic use (AOR = 4.86, 95% CI: 1.33\u201317.78), but not with antibiotic use (AOR = 1.75, 95% CI: 0.91\u20133.38) after adjusting for potential confounders. NTD risk associated with maternal antipyretic use was markedly higher for anencephaly (AOR = 7.03, 95% CI: 1.70\u201329.04) than for spina bifida (AOR = 3.98, 95% CI: 0.95\u201316.74). Mothers with flu or fever who were also using antipyretics showed a markedly higher AOR for anencephaly (14.75 vs. 4.52), spina bifida (16.30 vs. 3.85), and all NTDs combined (13.91 vs. 4.04) than mothers with flu or fever who were not using antipyretics. Maternal antibiotics did not markedly change the effects of flu or fever on anencephaly (4.17 vs. 4.83), spina bifida (5.08 vs. 4.21), and all NTDs combined (5.05 vs. 4.29). <jats:bold>CONCLUSIONS<\/jats:bold>: Maternal flu or fever and antipyretic use during the periconceptional period increases the risk for NTDs. Maternal exposure to antipyretics together with flu or fever results in a markedly higher risk of NTDs than exposure to flu or fever alone. Birth Defects Research (Part A), 2007. \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20342","type":"journal-article","created":{"date-parts":[[2007,1,10]],"date-time":"2007-01-10T20:48:20Z","timestamp":1168462100000},"page":"295-300","source":"Crossref","is-referenced-by-count":62,"title":["Maternal flu or fever, medication use, and neural tube defects: A population\u2010based case\u2010control study in Northern China"],"prefix":"10.1002","volume":"79","author":[{"given":"Zhiwen","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiguo","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanying","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200207000-00019"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000121381.79831.7b"},{"key":"e_1_2_6_5_1","first-page":"513","article-title":"Use of folic acid for prevention of spina bifida and other neural tube defects\u20141983\u20131991","volume":"40","author":"Centers for Disease Control\u2010CDC","year":"1991","journal-title":"MMWR"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0890-6238(95)00043-A"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780192618849.001.0001","volume-title":"Epidemiology and control of neural tube defects","author":"Elwood JM","year":"1992"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420440109"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420210114"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2003.00478.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00694.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20248"},{"key":"e_1_2_6_13_1","first-page":"252","article-title":"Prevalence of major external birth defects in high and low risk areas in China, 2003","volume":"26","author":"Li ZW","year":"2005","journal-title":"Chin J Epidemiol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117243"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490070064043"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/18.4.891"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9926(199801)57:1<1::AID-TERA1>3.0.CO;2-6"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20077"},{"key":"e_1_2_6_19_1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1542\/peds.92.4.559","article-title":"Association of the common cold in the first trimester of pregnancy with birth defects","volume":"92","author":"Zhang J","year":"1993","journal-title":"Pediatrics"}],"container-title":["Birth Defects Research Part A: Clinical and Molecular Teratology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdra.20342","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdra.20342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T18:05:47Z","timestamp":1700071547000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdra.20342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1,10]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2007,4]]}},"alternative-id":["10.1002\/bdra.20342"],"URL":"https:\/\/doi.org\/10.1002\/bdra.20342","archive":["Portico"],"relation":{},"ISSN":["1542-0752","1542-0760"],"issn-type":[{"value":"1542-0752","type":"print"},{"value":"1542-0760","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1,10]]}}}