Korean J Obstet Gynecol.  2003 Oct;46(10):1931-1936.

Pregnancy Outcome after Exposure of Suspected Teratogens in Early Pregnancy

• Kim HS
• Han JY
• Park SH
• Cho HJ
• Lim HJ
• Moon MJ
• Chung JH
• Choi JS
• Ahn HK
• Ryu HM
• Kim MY
• Kim JO
• Shin JS
• Choi KH
• Yang JH

Abstract

OBJECTIVE
To compare the risk of congenital anomaly after exposure to suspected teratogens in early pregnancy with the known baseline risk to the geneneral population.
METHODS
From September 1999 to August 2001, we counseled about the teratogenic risk of the fetus by relevant medical literatures after assessment of type, amount, and time of exposure for 302 pregnant women exposed to suspected teratogens such as drugs, radiation, alcohol, and cigarette smoking. We followed up on the pregnancy outcome with the rate of termination of pregnancy and incidence of congenital anomaly.
RESULTS
Among a total of 302 cases, 253 pregnant women (83.8%) delivered, 15 (5%) were aborted spontaneously, 34 (11.3%) were terminated. 297 pregnant women (98.3%) were lastly exposed to drugs in mean 5.3 +/- 0.2 gestational weeks. Medicines taken were gastrointestinal drugs (23%), NSAIDs (18.3%), antibiotics (16.2%), antihistamines (10.8%) in the order of frequency. 74 pregnant women (24.5%) were exposed to radiation in mean 5.1 +/- 0.5 gestational weeks. The mean dose was 234.60 mrem. 113 pregnant women (37.3%) lastly drank alcohol in mean 4.5 +/- 0.4 gestational weeks and the mean amount was 1.55 oz. 36 pregnant women (11.9%) lastly smoked in mean 4.4 +/- 0.3 gestational weeks and the mean amount was 7.3 cigarettes/day. We found structural anomalies in 5 cases (Polydactylyl, Ileal agenesis, Both ear mass, Left ectopic kidney, Meningomyelocele) and 1 chromosomal abnormality case (Trisomy18).
CONCLUSION
The rate of fetal structural anomaly was 2% in this study and is not more than baseline risk of general population. Therefore, evidence-based teratogenic risk counseling may prevent unnecessary pregnancy termination.

Keyword

Fetal anomaly; Suspected teratogen; Termination of pregnancy

MeSH Terms

Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Chromosome Aberrations
Counseling
Ear
Female
Fetus
Gastrointestinal Agents
Histamine Antagonists
Humans
Incidence
Kidney
Pregnancy
Pregnancy Outcome*
Pregnancy*
Pregnant Women
Smoke
Smoking
Teratogens*
Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Gastrointestinal Agents
Histamine Antagonists
Smoke
Teratogens