The perception of teratogenic risk of cocaine

Abstract

While there has been a substantial increase in recreational use of cocaine by young adults, conclusive evidence for cocaine teratogenicity in humans is lacking, and even those believing the drug is teratogenic agree that the rates are quite small. While counseling pregnant women on their teratogenic risk, it was our impression that there is an unrealistically high perception of reproductive risk of cocaine. We wished to quantify the perception of teratogenic risk of cocaine by the public, physicians, and by pregnant women who were counseled following gestational exposure to the drug. Women taking cocaine during the first trimester of pregnancy (n = 54), controls with post secondary education (n = 30), and physicians (n = 30) were asked, using a visual analogue scale, to quantify the teratogenic risk of cocaine and the tendency to terminate/continue the pregnancy after first trimester exposure; in the case of the "public" and physicians this was a hypothetical question. Both physicians and the controls perceived cocaine to be teratogenic (13.4 +/- 11% risk of major malformations by physicians, and 56.5 +/- 22.8% by the "public"). The controls believed cocaine to be as hazardous as thalidomide (57.2 +/- 25.6% risk for thalidomide). Asked whether they would wish to terminate such pregnancy in their family, most physicians (56%) and the controls (70%) had a greater than 50% tendency to terminate.(ABSTRACT TRUNCATED AT 250 WORDS)

Perception of teratogenic and foetotoxic risk by health professionals: a survey in Midi-Pyrenees area

“…It has been shown that the tendency to terminate pregnancy significantly decreased after an antenatal consultation about drug exposition. 11,12 Moreover, counselling can decrease the perception of teratogenic risk by women themselves. 13 Another point concerns the way the risk is communicated.…”

Vascular Disruption Birth Defects and History of Prenatal Cocaine Exposure: A Case Control Study

“…Review of the literature finds support for cocaine teratogenicity in the majority of reports [1][2][3][4][5], but not all [6][7][8], Animal studies clearly support the teratogenic po tential of cocaine [9,[13][14][15][16]20] by a vascular disruption mechanism. Chasnoff et al [1] reported an increased inci dence of genital tract malformations in neonates exposed to prenatal cocaine.…”

“…A number of studies support co caine teratogenicity [1][2][3][4][5] this association [6][7][8]. The pathogenic mechanism and unique pharmacokinetics of cocaine in pregnancy make it a likely candidate teratogen [9], Vascular accidents occur in adult users of cocaine [10][11][12], In addition, cocaine adversely alters maternal-fetal hemodynamics [13,14], However, the occurrence of a congenital anomaly require the specific time-dependent action of the drug in a suscep tible tissue, and the recognition of both the anomaly and the prenatal exposure.…”

Pregnancy and Commonly Used Drugs in Hematology Practice

“…8 It is also currently being used for myeloma, and thalidomide-like agents have become standard of care for multiple myeloma treatment. However, the suffering it caused has prompted the common belief that every drug has the potential to be a new thalidomide, 9 and patients commonly discontinue treatment and often unnecessarily consider an abortion of a wanted pregnancy. 10 There are only a limited number of drugs proven to be human teratogens, including thalidomide, isotretinoin, coumarin derivates, valproic acid, and folate antagonists.…”