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Related Experiment Videos

Teratogen update: vitamin A congeners.

F W Rosa, A L Wilk, F O Kelsey

    Teratology
    |June 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Vitamin A derivatives like isotretinoin and etretinate can cause birth defects and spontaneous abortions in humans, especially with early pregnancy exposure. Avoiding high-dose vitamin A during pregnancy is crucial for preventing teratogenic effects.

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    Area of Science:

    • Teratology
    • Dermatology
    • Pharmacology

    Background:

    • Animal studies since 1954 indicated vitamin A congener teratogenicity.
    • Human teratogenic findings emerged in 1983 with isotretinoin (ITR) for severe acne.
    • Etretinate (ETR), used for psoriasis, also shows teratogenic potential.

    Purpose of the Study:

    • To review human findings on vitamin A congener teratogenicity.
    • To highlight risks associated with isotretinoin and etretinate exposure during pregnancy.
    • To inform recommendations for vitamin A use in women of childbearing potential.

    Main Methods:

    • Review of reported human outcomes following isotretinoin and etretinate exposure.
    • Analysis of defect types, timing of exposure, and dosage.

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  • Comparison with animal study findings.

    • Main Results:

    • Isotretinoin linked to 44 defect outcomes and 33 spontaneous abortions, with critical exposure 2-5 weeks postconception.
    • Etretinate linked to 7 defect outcomes and 1 stillbirth, with cumulative effects due to long half-life.
    • High-dose vitamin A (retinol) linked to 18 suspicious birth defect outcomes, including CNS, CV, and clefts.

    Conclusions:

    • Isotretinoin and etretinate pose significant risks for birth defects and pregnancy loss.
    • Avoiding long-term, high-dose vitamin A (retinol) use in fertile women is warranted.
    • Further animal research is needed to better understand vitamin A analog risks and benefits.