{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:31:13Z","timestamp":1789637473474,"version":"4.0.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T00:00:00Z","timestamp":1494806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate whether exposure to clomiphene citrate (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) for ovulation induction is associated with major malformations overall or with specific fetal anomalies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We conducted a population\u2010based retrospective cohort study. Exposure was defined as <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> dispension from 2 months before conception through the first month of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Settings<\/jats:title><jats:p>Four databases were combined: medication, birth, hospitalization, and terminations of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>The study included all women in southern Israel who gave birth or underwent termination of pregnancy at Soroka Medical Center, from 1998 to 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The rates of major malformations overall and six different subcategories of anomalies were evaluated. The crude odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) was calculated with a 95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>). Subsequently the adjusted odds ratio (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>) was calculated using multiple logistic regression models controlling for maternal age, pre\u2010pregnancy diabetes, parity, ethnicity, the calendar year in which the birth\/termination of pregnancy took place, smoking, and the use of gonadotropins and progesterone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Major malformations overall and specific fetal malformations by organ systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 114 961 pregnant women, 1872 were exposed to <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>. No association was detected between exposure to <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> and rates of major malformations overall (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 1.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.88\u20131.32) or rates of subcategories of malformations. Exposure was not associated with anencephaly (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.27, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.44\u201311.71) or oesophageal atresia (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 3.681, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.65\u201320.76).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large population\u2010based retrospective cohort study, exposure to <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> was not associated with an increased risk of either rates of major malformations overall or rates of specific malformations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>An observational study: no increased risk for fetal malformations following exposure to clomiphene 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University of the Negev Beer\u2010Sheva Israel"},{"name":"BeMORE collaboration (Ben\u2010Gurion Motherisk Obstetric Registry of Exposure collaboration) Beer\u2010Sheva Israel"},{"name":"Department of Pediatrics Soroka Medical Center, Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Koren","sequence":"additional","affiliation":[{"name":"BeMORE collaboration (Ben\u2010Gurion Motherisk Obstetric Registry of Exposure collaboration) Beer\u2010Sheva Israel"},{"name":"The Motherisk Program Division of Clinical Pharmacology\u2013Toxicology Department of Pediatrics Hospital for Sick Children and The University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Lunenfeld","sequence":"additional","affiliation":[{"name":"The Motherisk Program Division of Clinical Pharmacology\u2013Toxicology Department of Pediatrics Hospital 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