ABSTRACT
The objective of this prospective multicenter study was to determine whether cisapride is associated with increased risk of malformations, spontaneous abortions, or decreased birthweight when used during pregnancy. Cases were paired for age, smoking, and alcohol consumption with controls exposed to nonteratogens, as well as with disease-paired controls. One hundred and twenty-nine pregnant women were exposed to cisapride during pregnancy, including 88 during the period of fetal organogenesis. There were no differences in maternal history, birthweight, gestational age at delivery, and rates of livebirths, spontaneous or therapeutic abortions, fetal distress, and major or minor malformations among groups. It is concluded that exposure to cisapride during pregnancy is not associated with a major increased risk of malformations or spontaneous abortions or with decreased birthweight.
Subject(s)
Abnormalities, Drug-Induced/epidemiology , Abortion, Spontaneous/chemically induced , Birth Weight/drug effects , Gastrointestinal Agents/adverse effects , Piperidines/adverse effects , Pregnancy Complications/drug therapy , Abnormalities, Drug-Induced/etiology , Adult , Case-Control Studies , Cisapride , Cohort Studies , Female , Gastrointestinal Agents/therapeutic use , Humans , Infant, Newborn , Piperidines/therapeutic use , Pregnancy , Prospective Studies , Risk FactorsABSTRACT
Cocaine has been implicated as a potential cause of congenital abnormalities since the mid 1980s. Clinical studies have reported an increased risk of cardiovascular and central nervous system abnormalities as well as an increased incidence of limb reduction defects and intestinal atresias. The published data have not established an unequivocal link between cocaine and these abnormalities. The most compelling evidence for the role of cocaine as a teratogen is the increased risk of genitourinary tract defects. Although animal models have also yielded contradictory conclusions, it is intriguing to note that the abnormalities observed in these models are similar to those seen clinically. This review summarizes the clinical and basic research relating to the teratogenic potential of cocaine.
Subject(s)
Abnormalities, Drug-Induced/etiology , Cocaine , Substance-Related Disorders , Animals , Drug Evaluation, Preclinical , Embryonic and Fetal Development/drug effects , Humans , Meta-Analysis as Topic , Retrospective Studies , Risk AssessmentABSTRACT
OBJECTIVE: Our purpose was to examine the potential teratogenicity of calcium channel blockers. STUDY DESIGN: Six teratogen information services prospectively collected and followed up 78 women with first-trimester exposure to calcium channel blockers. Pregnancy outcome was compared (by paired t text of chi2 analysis) with that of a control group matched for maternal age and smoking. RESULTS: There was no increase in major malformation (2/66=3.0% [calcium channel blockers] vs 0% [nonteratogenic controls], p=0.27); a fivefold increase was ruled out (baseline 2%, alpha = 0.05, beta = 0.20). The defects reported were attributable to maternal diabetes or coingestion of teratogens. The increase in preterm delivery 28% [calcium channel blockers] vs 9% [nonteratogenic controls], p=0.003), attributed to maternal disease by stepwise regression, was the most important factor responsible for the observed decrease in birth weight (mean -334 gm vs nonteratogenic controls, p=0.08). CONCLUSION: This study suggests that calcium channel blockers do not represent a major teratogenic risk.
Subject(s)
Abnormalities, Drug-Induced/etiology , Calcium Channel Blockers/adverse effects , Adult , Birth Weight/drug effects , Case-Control Studies , Chi-Square Distribution , Cohort Studies , Female , Follow-Up Studies , Humans , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, First , Prospective Studies , Regression AnalysisABSTRACT
In September, 1989, 35 individuals representing training programs for genetic counselors and genetic nurse specialists, the Education Committee of the National Society of Genetic Counselors (NSGC), and others with interest and expertise in genetic counselor education met at Asilomar, CA. The purpose of this meeting was to reevaluate training program curricula, both didactic and experiential; to discuss the need for and desirability of advanced graduate education in genetic counseling; and to consider whether alternatives to master's-level training are needed to overcome a growing manpower shortage in the provision of genetics services. This article summarizes recommendations for master's-level training curricula, reviews options and implications for post-master's genetic counselor education, and examines issues related to training for people without a master's degree who also provide patient and community genetics education.
