Castilla · Teratology 1996 · Retrospective registry/surveillance case-series · n=34

Thalidomide, a current teratogen in South America.

Cited 104 times in the scientific literature.

Level 4 - case-series / case-control

Case-series and birth defects registry analysis without a prospective controlled cohort.

PubMed 9098920 · doi:10.1002/(SICI)1096-9926(199612)54:6<273::AID-TERA1>3.0.CO;2-# · record verified 2026-08-27

What was done

The Latin American Collaborative Study of Congenital Malformations (ECLAMC) evaluated birth defect surveillance data using a case-reference approach to identify post-1965 cases of thalidomide embryopathy in South American regions where thalidomide is used for leprosy treatment.

What was found

ECLAMC registered 34 cases of thalidomide embryopathy born after 1965 in leprosy-endemic areas. Among the 11 cases that were fully described, phocomelia was present in 5.

Why it matters

This demonstrates that thalidomide continues to cause birth defects in areas where it is prescribed and that surveillance programs relying solely on phocomelia will fail to capture the full spectrum of thalidomide embryopathy.

Limits

Only 11 of the 34 identified cases had complete clinical descriptions reported. The surveillance system had low population coverage, relied on retrospective detection, and could not fully assess maternal drug intake timings.

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