Teratogenic Effects – Leadings to Neonatal Disorders

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Teratogen: 
A teratogen is an agent that can disturb the development of the embryo or foetus

Teratogenicity:
It refers to the capacity of a drug to cause foetal abnormalities when administered to the pregnant mother.

Drugs can affect the foetus at 3 stages:

Fertilization and implantation: conception to 17 days—failure of pregnancy which often goes unnoticed.

Organogenesis: 18 to 55 days of gestation, most vulnerable period, deformities are produced.

Growth and development: 56 days onwards —developmental and functional abnormalities can occur

Some Drugs and Its Teratogenic effects:

Thalidomide: Thalidomide is widely used drug in 1950 and early of 1960 to treat the morning sickness that caused in the pregnant women.

It has severe foetal abnormality of phocomelia which refers to a congenital deformity in which hands or feet are attached closed to the trunk   

Tetracyclines: Tetracyclines which are broad spectrum antibiotics when recommended as an antibiotic for a pregnant women it leads to Discoloration of teeth and retarded bone growth.

Phenytoin: Phenytoin which is widely used first line drug for Generalised tonic colonic seizures when administrated in the pregnant women results in the severe foetal abnormalities of cleft lip/palate syndrome.

Sodium Valproate: It is also a widely used Antiepileptic drug and a first line medication for Absence, Atonic and Myoclonic seizures when administered in the pregnant women leads to feoutal abnormalities of Spina Bifida a birth defect which leadings to incomplete closing of spinal cord during early development of pregnancy

Chloramphenicol: It is a broad spectrum antibiotic drug which is derived from Streptomyces venequelae when given to the preganant women results in Grey Baby Syndrome

ACE inhibitors: These are Antihypertensive agents when taken by the pregnant women results in hypoplasia of organs, growth retardation, foetal loss  

US – FDA has graded the risk for causing birth defects into five categories which are termed as

Category A : Adequate use of these drugs causes No Risk in Pregnancy

Category B: Usage of these drugs shows no evidence of risk in humans

Category C: These are the drugs in which major risks are not predicted in humans can be used upon potential benefits and may have potential risks too

Category D: Evidences of risk in human foetal are employed, but the potential benefits from usage of drugs may be acceptable

Category X: These are the drugs which are contraindicated in pregnancy, studies in animal and human foetus demonstrated high risk and foetal abnormalities in pregnancy.

Pregnant women may have several risks of foetal abnormalities by excessive usage of medications. Prescribed drugs are to be necessarily used during the time of pregnancy and conception.

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Annabela Rose
Editorial Assistance
Clinics in Mother and Child Health
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