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Introduction to Drugs and Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Maternal complications and fetal effects due to drug or chemical exposures are not considered under the rubric of classical teratology, but the discovery of drugs and other agents with such potential adverse effects parallels the pattern of the discovery of human teratogens. The untoward fetal effects are called fetotoxic or adverse fetal effects, and maternal effects are termed maternal toxic or adverse maternal effects. However, even seasoned human teratologists blur the line between embryonic and fetal effects sometimes.
Preconceptual Health
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Nancy L. Eriksen, Kristi R. VanWinden, John McHugh
The six basic principles of teratology were outlined in the 1970s and provide a framework for evaluating the teratogenic propensity of an exposure. Based on these principles, a teratogen is expected to demonstrate variable effects based on genetic susceptibility, gestational timing, and the degree of tissue exposure. It should manifest a spectrum of outcomes, with a dose–response effect ranging from no observable effect to lethality. It is also expected to act via specific mechanisms, thus leading to a characteristic pattern of findings.52,53 When post-market drug surveillance demonstrates a data signal consistent with these principles, a more directed study is warranted.
Principles of teratology of drugs and radiation
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Teratology is the study of birth defects. In this chapter, the potential of drugs and radiation to produce birth defects in humans will be explored. Wilson (1) has estimated that of all human malformations, less than 1% are due to radiations and 4% to 6% are due to drugs and environmental chemicals.
Comparison of the groups treated with mirtazapine and selective serotonine reuptake inhibitors with respect to birth outcomes and severity of psychiatric disorder
Published in Psychiatry and Clinical Psychopharmacology, 2019
Buket Belkız Güngör, Nalan Öztürk, Ayça Öngel Atar, Nazan Aydın
The widespread usage of SSRIs provides knowledge related to the effects of SSRIs on the developing fetus during pregnancy and on neonatal outcomes after delivery. However, there is limited information related to mirtazapine usage and its effects on pregnancy outcomes. The off label use of mirtazapine for morning sickness has been increasing gradually in pregnant women [11]. More information is needed about its use in pregnant women with psychiatric symptoms. The literature offers insufficient information about the comparison of SSRI and mirtazapine usage in pregnancy, including the clinical course of mental disorders and birth outcomes. Although two studies compared a mirtazapine and an SSRI group according to the rates of congenital malformations and birth outcomes, the data of this study was obtained from a Teratology Information Service and contained no information related with the psychiatric follow up and the characteristics of the psychiatric patient group [12,13].
Review of Ilana Löwy, Imperfect Pregnancies: A History of Birth Defects & Prenatal Diagnosis
Published in The American Journal of Bioethics, 2019
Chapter 3 examines the identification of and concerns over environmental teratogens in the 1960s. This includes the rubella and thalidomide crises, which generated much concern in women who feared they would give birth to a malformed child, and ultimately led to greater sympathy and public acceptance of abortion. Löwy places her discussion in the broader context of the efforts by scientists interested in fetal malformation to rename the field of teratology as dysmorphology, with the hope it would destigmatize birth defects previously labeled as “monstrosities.” At this time, visibility of birth defects was increasing through national and international registries, created to identify unusual anomalies potentially caused by environmental teratogens. As a consequence, eliminating birth defects became a public health concern. This chapter also discusses the increase in obstetric ultrasound to identify structural fetal malformations in the 1970s and 1980s as ultrasound resolution increased and it became a routine component of prenatal care.
Use of synthetic and biologic DMARDs during pregnancy
Published in Expert Review of Clinical Immunology, 2019
Gustavo Guimarães Moreira Balbi, Vinicius Domingues, Gabriela Guimarães Moreira Balbi, Guilherme Ramires De Jesús, Roger Abramino Levy
Pharmaceutical companies are already publishing registries data of post-marketing surveillance, as presented in the body of the paper, with good results. The Organization of Teratology Information Services (OTIS) is also continuously conducting studies to evaluate the teratogenicity of biologics and small molecules. A European effort to build robust registries of biologic exposures in pregnancy is now becoming a reality. The European Network of Pregnancy Register in Rheumatology is meant to unify data from different countries and includes the following registries: German Rhekiss, Swiss pregnancy section of the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM), French National Pregnancy in Rheumatic Diseases Registry, and REVNATUS (Norwegian pregnancy registry of women with rheumatic diseases). Included patients will be prospectively monitored before conception, throughout pregnancy and post-partum [3].