921
taking Communion without wafers, she no longer had abdominal cramps, bloating, or diarrhoea. Therefore we add the ingestion of Communion wafers as a cause of refractory coeliac disease.
Department of Medicine, St Michael’s Hospital,
H. PRICE J. ZOWNIR E. PROKIPCHUK
30 Bond Street,
Toronto, Ontario.
ASSOCIATION BETWEEN MATERNAL INTAKE OF DIAZEPAM AND ORAL CLEFTS
SIR,—The results of retrospective studies in the U.S.A. (Sept. 13, p. 478) and in Finland (Sept. 13, p. 498) suggested the possibility of an association between prenatal exposure to diazepam and oral clefts. Infants with oral clefts treated at the Children’s Hospital in Bergen during 1967-71 have also been studied retrospectively.
Infants with additional major birth defects
questionary on family history and drug consumption during DRUG INTAKE
DURING
were excluded. A and diseases, X-ray exposure, the first trimester was sent to
ABO BLOOD TYPES IN CONGENITAL HEART-DISEASE SIR,—Three communications in The Lancet within the past few years have discussed a possible association between the ABO blood-group system and congenital heart-disease (C.H.D.). The first,’ from Norway, suggested an excess of group A among patients with ventricular septal defect, but not among those with atrial septal defect; the second,2 from the West of England, showed no such association; the thirdreported a deficit of group B in two series of children with C.H.D.—one collected in New Haven, Connecticut, and the other in Denver, Colorado. We have examined this postulated relation in data collected by the collaborative perinatal project of the National Institute of Nervous Diseases and Stroke .4 From a cohort of 50 282 infants born between 1959 and 1966 in twelve university-affiliated hospitals in ten States of the United States of America, a subset of 38 383, each TABLE I-BLOOD-GROUPS AND C.H.D.
’
FIRST TRIMESTER IN MOTHERS OF INFANTS WITH
ORAI, Cl t?FTS AND THROUGHOUT PREGNANCY IN CONTROI MOTHERS
Expected numbers in parentheses. c.n.- clett palate. .i +C.P. - cleft lip with
or
without cleft
palate.
130 mothers. Questions on drug usage were directed towards the possible ingestion of anticonvulsants, since the first reports of an association between exposure to phenytoin and an in2 crease in the frequency of oral clefts had lately appeared. 1 The intake of progestins or progestins and oestrogens was investigated so that the use of these drugs in pregnancies resulting in offspring with oral clefts and in pregnancies3 resulting in offspring with hypospadias could be compared. III questionaries were completed. There was a family history of oral clefts in 52 cases. 21 mothers had a history of acute illness in the first trimester, 7 had been exposed to X-rays, and 32 mothers reported taking drugs other than vitamin and iron
preparations. A group of normal controls sampled by the Medical Birth Registry of Norway during the period from autumn 1972 to spring 1975 has been included in the accompanying table for comparison.49 9 (2.5%) of the control mothers had used diazepam during pregnancy. However, when only first trimester drug consumption was considered, it appeared that only 4, or 1.1% of the controls had used diazepam as compared to 7, or 6.3%, of mothers of infants with oral clefts. These frequencies were significantly different by the y.2 test (r
taking Communion without wafers, she no longer had abdominal cramps, bloating, or diarrhoea. Therefore we add the ingestion of Communion wafers as a cause of refractory coeliac disease.
Department of Medicine, St Michael’s Hospital,
H. PRICE J. ZOWNIR E. PROKIPCHUK
30 Bond Street,
Toronto, Ontario.
ASSOCIATION BETWEEN MATERNAL INTAKE OF DIAZEPAM AND ORAL CLEFTS
SIR,—The results of retrospective studies in the U.S.A. (Sept. 13, p. 478) and in Finland (Sept. 13, p. 498) suggested the possibility of an association between prenatal exposure to diazepam and oral clefts. Infants with oral clefts treated at the Children’s Hospital in Bergen during 1967-71 have also been studied retrospectively.
Infants with additional major birth defects
questionary on family history and drug consumption during DRUG INTAKE
DURING
were excluded. A and diseases, X-ray exposure, the first trimester was sent to
ABO BLOOD TYPES IN CONGENITAL HEART-DISEASE SIR,—Three communications in The Lancet within the past few years have discussed a possible association between the ABO blood-group system and congenital heart-disease (C.H.D.). The first,’ from Norway, suggested an excess of group A among patients with ventricular septal defect, but not among those with atrial septal defect; the second,2 from the West of England, showed no such association; the thirdreported a deficit of group B in two series of children with C.H.D.—one collected in New Haven, Connecticut, and the other in Denver, Colorado. We have examined this postulated relation in data collected by the collaborative perinatal project of the National Institute of Nervous Diseases and Stroke .4 From a cohort of 50 282 infants born between 1959 and 1966 in twelve university-affiliated hospitals in ten States of the United States of America, a subset of 38 383, each TABLE I-BLOOD-GROUPS AND C.H.D.
’
FIRST TRIMESTER IN MOTHERS OF INFANTS WITH
ORAI, Cl t?FTS AND THROUGHOUT PREGNANCY IN CONTROI MOTHERS
Expected numbers in parentheses. c.n.- clett palate. .i +C.P. - cleft lip with
or
without cleft
palate.
130 mothers. Questions on drug usage were directed towards the possible ingestion of anticonvulsants, since the first reports of an association between exposure to phenytoin and an in2 crease in the frequency of oral clefts had lately appeared. 1 The intake of progestins or progestins and oestrogens was investigated so that the use of these drugs in pregnancies resulting in offspring with oral clefts and in pregnancies3 resulting in offspring with hypospadias could be compared. III questionaries were completed. There was a family history of oral clefts in 52 cases. 21 mothers had a history of acute illness in the first trimester, 7 had been exposed to X-rays, and 32 mothers reported taking drugs other than vitamin and iron
preparations. A group of normal controls sampled by the Medical Birth Registry of Norway during the period from autumn 1972 to spring 1975 has been included in the accompanying table for comparison.49 9 (2.5%) of the control mothers had used diazepam during pregnancy. However, when only first trimester drug consumption was considered, it appeared that only 4, or 1.1% of the controls had used diazepam as compared to 7, or 6.3%, of mothers of infants with oral clefts. These frequencies were significantly different by the y.2 test (r
