In a study of more than 3 million pregnancies, University of Florida researchers found 1 in 16 women were exposed to harmful teratogenic drugs — medications that can cause pregnancy loss, birth defects, and other health problems for the unborn child.
Researchers investigated more than 200 teratogenic drugs and evaluated their exposure among 3.4 million pregnancies identified in a national private insurance database from 2006 to 2017. Prenatal exposure was defined by the mother taking at least one teratogenic drug during pregnancy. A teratogen is a substance that interferes with the normal development of a fetus. Hundreds of such drugs have been identified, including medications to treat seizures, migraines, obesity, acne, hypertension, bipolar disease, and cancer.
Using teratology drug databases, the medications were separated into two classes based upon their known teratogenic effect. About 140 drugs were known to have definite teratogenic effects, and another 65 were identified as having potential teratogenic effects. The proportion of pregnancies with exposure to definite teratogens decreased slightly over the 12-year study period from 1.9 percent to 1.2 percent, while exposures for potential teratogens increased from 3.4 percent to 5.3 percent.
“While declining exposure rates among teratogenic drugs with definite risk are encouraging, the rising prenatal exposure to drugs with potential risk calls for more assessment,” said Almut Winterstein, an author of the study and distinguished professor and chair of the department of pharmaceutical outcomes and policy in the University of Florida College of Pharmacy. “To have 1 in 16 women and their unborn baby exposed to a teratogenic medication is simply too high, and we must identify strategies to improve pregnancy outcomes.
“If you are pregnant, planning to become pregnant, or sexually active you must understand the risks involved with taking teratogenic drugs,” added Dr. Winterstein. “Talk with your provider about your medications and review drug labels to ensure the medications you are taking are not putting your unborn child at risk.”
The full study “Prenatal Exposure to Teratogenic Medications in the Era of Risk Evaluation and Mitigation Strategies,” was published on the website of the American Journal of Obstetrics and Gynecology. It may be accessed here. Amir Sarayani, a doctoral candidate in the University of Florida College of Pharmacy under Dr. Winterstein’s mentorship, served as the lead author of the paper.