[Perinatal drug administration and risks of functional teratogenic defects]

The success of perinatal medicine in saving the risk pregnancies and the lives of very immature and injured newborns is connected with a growing use of drugs which may disturb perinatal ontogenetic processes characterized by intensive histogenesis and cytodifferentiation of already formed organs, predominantly the brain. The administered drugs can change the program of the formation of neural nets, synapses, receptors and neurotransmitters and induce permanent deviations of brain cytoarchitectonics and neurobiochemical equipment. This pathology is not evident at birth, but forms the basis for functional defects of the brain which become apparent gradually during maturation or even in adulthood as neuro-psychological deviations e.g. minimal brain dysfunction or mental retardation in school children, sensori-motor deficits, epilepsy, psychic lability and maladjustment which may represent a predisposition to psychoses. Clinical recognition of this functional teratogenic action of the drug is hampered by the long time interval (upto decades) between the drug administration and its consequences what makes the identification of causal relations very difficult. Consequently, experimental research is necessary concerning functional teratogenicity of all drugs given in perinatal period, however under the precondition of adequate animal models with sufficient validity for the extrapolation on human level. The synopsis of current knowledge in this field reveals great numbers of urgent problems which are to be studied.