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Perception of teratogenic risk by pregnant women exposed to drugs and chemicals during the first trimester

  • Author Footnotes
    a Drs. Koren and Shear are Career Scientists of the Ontario Ministry of Health.
    Gideon Koren
    Correspondence
    Reprint requests: Dr. G. Koren, MD, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8.
    Footnotes
    a Drs. Koren and Shear are Career Scientists of the Ontario Ministry of Health.
    Affiliations
    Division of Clinical Pharmacology and The Motherisk Program, the Department of Pediatrics and The Research Institute, The Hospital for Sick Children and Sunnybrook Medical Center, and the Departments of Pharmacology, Medicine, and Pediatrics, University of Toronto, Toronto, Ontario, Canada
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  • Monica Bologa
    Affiliations
    Division of Clinical Pharmacology and The Motherisk Program, the Department of Pediatrics and The Research Institute, The Hospital for Sick Children and Sunnybrook Medical Center, and the Departments of Pharmacology, Medicine, and Pediatrics, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • David Long
    Affiliations
    Division of Clinical Pharmacology and The Motherisk Program, the Department of Pediatrics and The Research Institute, The Hospital for Sick Children and Sunnybrook Medical Center, and the Departments of Pharmacology, Medicine, and Pediatrics, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • Yaacov Feldman
    Affiliations
    Division of Clinical Pharmacology and The Motherisk Program, the Department of Pediatrics and The Research Institute, The Hospital for Sick Children and Sunnybrook Medical Center, and the Departments of Pharmacology, Medicine, and Pediatrics, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • Author Footnotes
    a Drs. Koren and Shear are Career Scientists of the Ontario Ministry of Health.
    Neil H. Shear
    Footnotes
    a Drs. Koren and Shear are Career Scientists of the Ontario Ministry of Health.
    Affiliations
    Division of Clinical Pharmacology and The Motherisk Program, the Department of Pediatrics and The Research Institute, The Hospital for Sick Children and Sunnybrook Medical Center, and the Departments of Pharmacology, Medicine, and Pediatrics, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author
  • Author Footnotes
    a Drs. Koren and Shear are Career Scientists of the Ontario Ministry of Health.
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      Abstract

      We assessed the perception of teratogenic risk by 80 women attending an antenatal consultation service for drug, chemical, and radiation exposure. Women exposed to agents not known to be teratogenic assigned themselves a risk of 24% ± 2.8% for major malformation before the relevant medical literature was delivered to them and 14.5% ± 3% thereafter. These women accurately estimated the risk for major malformation in the general population (5.6% ± 1.3%). The tendency to terminate pregnancy when exposed to a nonteratogen significantly decreased after the consultation. Eleven patients exposed to drugs known to be teratogenic assigned a risk of 36.2% ± 11.7% before the interview and did not change their perception thereafter (36.7% ± 15.8%). Similarly, their tendency to continue or terminate pregnancy did not change; three of them eventually chose to terminate the pregnancy. Advising women about their teratogenic risk early in pregnancy may prevent unjustified termination of many pregnancies and may help to inform women exposed to proven teratogens about the known risk. (Am J Obstet Gynecol 1989;160:1190-4.)

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      References

        • Heinonen OP
        • Slone D
        • Shapiro S
        Birth defects and drugs in pregnancy. PSG, Littleton, Mass.1977
        • Briggs GG
        • Freeman RK
        • Yaffe SJ
        Drugs in pregnancy and lactation.2nd ed. Williams & Wilkins, Baltimore1986
        • Shepard TH
        Catalog of teratogenic Agents.5th ed. Johns Hopkins University Press, Baltimore1986
        • Mitchell A
        Drugs and birth defects.
        Clin Toxicol Rev. 1982; 4: 1-4
        • Harbison RD
        Teratogens.
        in: Klaasen CD Amdur MO Doull J Cassarett and Doull's toxicology. Macmillan, New York1980: 158-175
        • Rubrin PC
        • Craig GF
        • Gavin K
        • et al.
        Prospective survey of use of therapeutic drugs, alcohol and cigarettes during pregnancy.
        Br Med J. 1986; 292: 81-85
        • Koren G
        • MacLeod SM
        Monitoring and avoiding drug and chemical teratogenicity.
        Can Med Assoc J. 1986; 135: 1079-1081
        • Koren G
        • Feldman Y
        • Shear N
        Motherisk-a new approach to antenatal counselling of drug chemical exposure.
        Vet Hum Toxicol. 1986; 28: 563-565
      1. Macpherson AS. Health status report 1983. City of Toronto, Dept. of Public Health. April 1985:37.

        • Shain RN
        A cross-cultural history of abortion.
        Clin Obstet Gynecol. 1986; 13: 1-17
        • Gerbie AB
        • Elias S
        Amniocentesis for antenatal diagnosis of genetic defects.
        Clin Obstet Gynecol. 1980; 7: 5-12
        • Lenz W
        Thalidomide embryopathy in Germany.
        19591961.Prog Clin Biol Res. 1985; 163c: 77-83
        • Schardein JL
        Chemically induced birth defects. Marcel Dekker, New York1985
        • Scher J
        Will my baby be normal? How to make sure. Dial, New York1983: 31
        • Elkington J
        The poisoned womb. Viking, London1985