{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:44:32Z","timestamp":1773233072476,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Japanese traditional (Kampo) medicines containing ephedra are used to relieve symptoms of the common cold during pregnancy. The risks associated with perinatal outcomes, however, remain unclear. Thus, we evaluated the risk of adverse perinatal outcomes associated with the use of Kampo medicines containing ephedra during pregnancy using data from the Tohoku Medical Megabank Project Birth and Three\u2010Generation Cohort Study (TMM BirThree Cohort Study).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Questionnaires were distributed to pregnant women who participated in the TMM BirThree Cohort Study at approximately weeks 12 and 26 of pregnancy. Adverse perinatal outcomes in women who used Kampo medicines containing ephedra or acetaminophen during pregnancy were assessed. Odds ratios (ORs) were estimated using weighted logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 20\u2009083 pregnant women, acetaminophen and Kampo medicines containing ephedra were used by 5.3% and 3.5% of women, respectively. The OR for caesarean section was 0.95 (95% confidence interval [CI], 0.75\u20131.20), for preterm birth (PTB) was0.99 (95% CI, 0.63\u20131.55), for low birth weight (LBW) was 1.04 (95% CI, 0.72\u20131.49), for small for gestational age (SGA) was 0.98 (95% CI, 0.58\u20131.65), and for low Apgar scores at 5\u2009min was 0.85 (95% CI, 0.25\u20132.93) in the women who used Kampo medicines containing ephedra during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No statistically significant association was seen between the use of Kampo medicines containing ephedra during pregnancy and an increased risk of needing a caesarean section, PTB, LBW, SGA, or low Apgar scores. Although further research is needed, this study may assist in clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70251","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T04:25:36Z","timestamp":1762230336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perinatal Outcomes After the Use of Kampo Medicines Containing Ephedra During Pregnancy"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7644-6848","authenticated-orcid":false,"given":"Aoi","family":"Noda","sequence":"first","affiliation":[{"name":"Tohoku Medical Megabank Organization Tohoku University  Sendai Japan"},{"name":"Department of Molecular Epidemiology, Graduate School of Medicine Tohoku University  Sendai Japan"},{"name":"Department of Pharmaceutical Sciences Tohoku University Hospital  Sendai 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