Associations between Drugs Administered during Pregnancy and Congenital Abnormalities of the Fetus

Abstract

SummaryIn a retrospective study to compare the drug consumption during pregnancy of mothers of infants with congenital abnormalities and of those without, over 97% of 1,369 mothers took prescribed drugs and 65% self-administered drugs. Significantly more mothers of infants with congenital abnormalities took aspirin, antacids, dextroamphetamine, phenobarbitone, sodium amytal, other barbiturates, cough medicines, iron, sulphonamides, and nicotinamide than mothers in the control group. However, most mothers taking analgesics, antacids, appetite suppressants, barbiturates, cough medicines, iron, sulphonamides, and vitamins produced normal infants. Any teratogenic effect of these drugs is therefore one of low potency. On the other hand, deficiencies such as those of ascorbic acid and folic acid may have a teratogenic effect. There is need for caution in presuming teratogenic effects on the basis of the associations shown here. During pregnancy, however, it would appear wise to avoid the administration of any drug which carries a suspicion of teratogenicity unless that drug is specifically indicated, and selfmedication with common household remedies such as aspirin and antacids should be avoided. These recommendations would also apply to any woman of childbearing age in whom conception is likely. IntroductionAs part of a survey into the aetiology of congenital malforrnations the drug consumption of pregnant mothers, both of

Maternal Behavior and Perinatal Risks: Alcohol, Smoking, and Drugs

“…"Over-the-Counter" Drugs Earlier reports (33,34,35) indicated that (a) fewer than 10% of pregnant women completed their pregnancies without any drugs having been ad vised, (b) 65% took self-prescribed drugs, and (c) among women who ingested drugs during pregnancy, 80% of the drugs were taken without medical advice.…”

Ascorbic acid status in third trimester of pregnancy, at delivery and in cord blood

“…According to Nino and Shaw (5), decreased maternal ascorbic acid has been associated with premature/low birth, pre-enclampsia, anaemia and premature rupture of the foetal membrane. Nelson and Tagfer (6) …”

Antibiotics in pregnancy: Toxicity and teratogenicity

“…In animals, malformations could be experimentally produced by sulfonamides (24), but in man there is only little evidence to suggest teratogenic effects. Only a few retrospective studies suggest a slight association of sulfonamides with malformations (2,25). Another side-effect of sulfonamides is caused by the competition of sulfonamides with bilirubin at common serum binding sites (26).…”

“…About 37% of the drugs used were antibiotics. In another study (2), 28% to 38% of the pregnant mothers had taken antibiotics. Considering carefully the advantages and the possible damage related to drug use, antibiotics in particular well illustrate the situation of the prescriber, who is often sailing between Scylla and Charybdis.…”