Teratogens Flashcards
When are you most sensitive to malformations during pregnancy?
18-60 days
Doses of drugs and teratogenic impact
- the higher the dose, the higher the risk to the fetus
- some drugs have a threshold of theratogenicity
types of teratogenicity
- alterations in fertility
- gene mutations or chromosomal breaks in egg/sperm
- pregnancy loss
- birth defects
- fetal growth retardation
- alterations in intellect or behavior
- carcinogenicity
confounding factors and teratogens
- poor prenatal care
- maternal nutrition
- maternal illness
- polytherapy
inheritance of addiction
- biological reason poorly understood
- many studies observed that it runs in family
- may be addiction genes or related to depression, bipolar or ADHD
almost ____ % of american women are abstinent from alcohol
40
________ children are born with fetal alcohol syndrome in US each year.
4000
- completely preventable
who is at risk for fetal alcohol syndrome?
- teens
- indigent
- women with mental health issues
- certain ethnic groups
assessment for risk of drinking during pregnancy
- laboratory tests like urine toxicology
- questionnaires
4 Ps and alcohol and pregnancy
4 yes/no questions asked during patient’s current pregnancy, in her past, in her partner and in her parents
- one positive answer is any question to considered an overall positive screen for a risk drinker
NET alcohol and pregnancy
- do you consider yourself a normal drinker?
- do you ever have an eye-opener?
- how many drinks does it take to make you feel high?
Tobacco and increased risk during pregnancy
- intrauterine growth retardation
- prematurity
- stillbirth
- facial clefts
- learning disorders
- hyperactivity
Breastmilk and tobacco
amounts proportional to number of maternal cigarettes
What is postnatal exposure to tobacco associated with?
SIDS
asthma
ear infections
Smoking cessation not recommended in pregnancy
- varencline
- nicotine vaccine
E-cigs
- heated nicotine
- may include pot
- avoids exposure to carcinogens
- varying evidence to pregnancy
Alcohol and pregnancy
- pregnancy loss
- fetal alcohol syndrome
Fetal alcohol syndrome
- growth retardation
- CNS dysfunction
- characteristic facial features
- malformations
Binge drinking and pregnancy
- may be as risky as daily use of moderate amounts
breastmilk and alcohol
equal to maternal blood concentrations
- more than one drink a day may result in drowsiness, developmental delays
Facial characteristics of fetal alcohol syndrome
- flat philtrum
- thin upper lip
- microcephaly
- flat maxillary area
Pot and pregnancy
- minimal risk for birth defects
- some subtle behavioral changes
- chronic use in 3rd trimester may cause problems with newborn adaptation
- extorted in breast milk
cocaine and pregnancy
- obstetrical complications
- intrauterine growth
- small risk for malformations
- neonatal behavioral abnormalities disappear in first few months of life
- SIDs
cocaine and breastmilk
- vomiting
- tremulousness
- irritability
- seizures
Meth and pregnancy
- do not show significant risk for malformations
- 3rd trimester: low birth weight, prematurity and withdrawal symptoms
- longterm impact on cognition and behavior
heroin and pregnancy
- small risk for malformations
- longer term behavior
- IUGR
- prematurity
- fetal distress
- perinatal mortality
- SIDS
Heroin and withdrawal in pregnancy
diarrhea, fever, convulsions, sleep abnormalities, respiratory distress
heroin and breast milk
can cause addiction
prescription narcotics and pregnancy
addicted newborns tripled between 2000 and 2009
- risk for malformations low
- neonatal abstinence syndrome big problem
OUD pregnancy
- 6x increase in OB complications
- maternal withdrawal during pregnancy presents risk to fetus
