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Pregnant women, prescription, and fetal risk

Elisabeth Eléfant1, Cyril Hanin2, David Cohen3

  • 1Centre de Référence sur les Agents Tératogènes, Hôpital Armand-Trousseau, Paris, France.

Handbook of Clinical Neurology
|September 22, 2020
PubMed

Since the historical scandal of thalidomide in the 1960s, practitioners and future mothers are fearful of drugs during pregnancy. In-uterine exposure to drugs can induce major malformation of the fetus or even intrauterine fetal death. Prescribing drugs to a pregnant woman requires particular attention, and it is necessary to consider both the maternal needs and the proven and potential fetal risks. In this chapter, we review the mechanisms for medication transfer from mother to fetus, fetal risk according to pregnancy timeline, and the main dangerous drugs during pregnancy. We also focus on three prescription debates, which are relevant for neurodevelopmental disorder, because they each point to a paradigmatic situation-diethylstilbestrol, which shows transgenerational adversary effects; valproate, which impacts neurodevelopment as a whole; and antidepressants for which the adverse impact on neurodevelopment is still controversial given the impact of depression itself. Finally, we consider the implications for practice and toxicologic research to promote risk prevention.

Keywords:
Fetal riskPregnancyPrescriptionTeratogenicity

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