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Methods Animal studies All animal experiments were approved by the Institutional Animal Care and Use Committee (IACUC) of Nanjing Medical University (IACUC-2306028) (Nanjing, China)

7 In addition to the primary analysis, we conducted a sensitivity analysis to include all reported birth defects, irrespective of aetiology including those of genetic or chromosomal origin and those occurring due to intrauterine infections

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