Effects of teratogens on prenatal development

Teratogens are drugs, chemicals, or even infections that can cause abnormal fetal development. There are billions of potential teratogens, but only a few agents are proven to have teratogenic effects. These effects can result in a baby being born with a birth defect. Approximately 4 to 5 percent of birth defects are caused by exposure to a teratogen.

The majority of agents that people come into contact with aren’t proven teratogens. Talk to your doctor if you’re concerned about being exposed to a particular medication, chemical, or infection during pregnancy.

Researchers believe a teratogen can affect a developing fetus about 10 to14 days after conception.

The best way to reduce the risk of exposure to teratogens during pregnancy is to avoid taking medications when possible and to avoid exposure to the following:

Avoid prolonged stays in whirlpools, steam rooms, or saunas.

Talk to your doctor before you start taking any over-the-counter supplements during pregnancy. Products that claim to be natural may not necessarily be safe to use during pregnancy.

If your doctor orders a test with possible radiation exposure during your pregnancy, they must strongly believe that the risk of exposure is less than the risk of an untreated or undiagnosed condition. In most cases, the lower abdomen can be shielded with a protective apron to prevent exposure.

It isn’t always possible to avoid sick children, and in most cases, exposures only lead to minor illnesses. When you can, it’s best to avoid such exposures while you’re pregnant. Every parent knows that the easiest place to acquire an illness is in a day care center or school, so avoid these locales as much as possible.

Certain infections can be passed from child to adult, including chickenpox, rubella, and cytomegalovirus (CMV). Adults are immune to many of these diseases. In some cases, however, the exposure may result in an infection that can affect the baby while in the womb. If you’ve been exposed to a known viral or bacterial illness, call your doctor right away so they can decide whether a blood test is needed.

Toxoplasmosis is an infection that can be transmitted from cat feces to humans. If you’re pregnant and have a cat, you should minimize your exposure to the litter box as much as possible. Ask someone else in your household to clean the litter box. If you don’t have anyone to help you with the litter, clean the litter box every day to reduce your risk of contracting toxoplasmosis. You don’t need to get rid of your cat.

You should also avoid known teratogens. These include

  • angiotensin converting enzyme (ACE) inhibitors, such as Zestril and Prinivil
  • alcohol
  • aminopterin
  • androgens, such as methyltestosterone (Android)
  • busulfan (Myleran)
  • carbamazepine (Tegretol)
  • chlorobiphenyls
  • cocaine
  • coumarins
  • warfarin (Coumadin)
  • cyclophosphamide (Cytoxan)
  • danazol (Danocrine)
  • diethylstilbestrol (DES)
  • etretinate (Tegison)
  • isotretinoin (Accutane)
  • lead
  • lithium (Eskalith)
  • mercury
  • methimazole (Tapazole)
  • methotrexate (Rheumatrex)
  • penicillamine (Depen, Cuprimine)
  • phenytoin (Dilantin)
  • phenobarbital (Solfoton)
  • propylthiouracil (PTU)
  • prostaglandins
  • radioactive iodine
  • tetracycline (Sumycin)
  • tobacco
  • trimethadione (Tridione)
  • valproic acid (Depakene)

Some of these agents are easy to avoid. Others may be required for a medical condition and are unavoidable. For instance, you may require phenytoin to control your seizures if you’re pregnant and you have epilepsy. Despite the risk of teratogenic effects, you may be better off taking the phenytoin than risking the occurrence of uncontrolled seizures during pregnancy.

If you need treatment with any of the medications that are known teratogens and you’re pregnant, ask your doctor to send you to a geneticist. Geneticists specialize in the effects of teratogens on fetuses and can help you assess your actual risk given a specific exposure. You may also receive a targeted ultrasound evaluation to determine whether the fetus has been affected in some way.

What is a teratogen?

A teratogen is something that can cause or raise the risk for a birth defect in a baby. They are things that a mother may be exposed to during her pregnancy. Teratogens include:

  • Some medicines

  • Street drugs

  • Alcohol

  • Tobacco

  • Toxic chemicals

  • Some viruses and bacteria

  • Certain health conditions, such as uncontrolled diabetes

How to say it

ter-AT-uh-jehn

The riskiest times of pregnancy

Experts believe that teratogens can begin affecting a baby growing in the womb about 10 to14 days after conception. Conception is when a woman’s egg is fertilized by a man’s sperm. After conception, it takes about 6 to 9 days for the egg to implant in the uterus. Once the fertilized egg is attached to the uterus, the mother and the embryo share a blood supply. Chemicals in the mother's blood can then affect the growing baby.

As a baby grows in the womb, teratogens may affect parts of the baby’s body as they are forming. For example, the neural tube closes in the first 3 to 5 weeks of the pregnancy. During this time, teratogens can cause neural tube defects such as spina bifida. Some organs are sensitive to teratogens during the whole pregnancy. This includes the baby's brain and spinal cord. Alcohol affects the brain and spinal cord, so it can cause harm at any time during pregnancy. This is why you should not drink alcohol if you are pregnant.

How are teratogens known?

Researchers have two ways of finding out if a substance is a teratogen. They are:

  • Animal studies. Animal studies are the main way to find out if a medicine or other substance is safe during human pregnancy.

  • Observations from human exposure. This means reports of problems about a substance over time.

What are nonteratogenic agents?

Certain things have been shown to not cause birth defects. These are called nonteratogenic agents. These include:

  • Spermicides. These are chemicals that kill sperm to prevent pregnancy. These chemicals are found in products for birth control, such as gels, creams, and foams, and on some condoms. Studies have shown no link with the use of spermicides and any increased chance for birth defects.

  • Acetaminophen. This is a common ingredient in some pain medicines. There has been no link between birth defects and taking acetaminophen at the advised dose during pregnancy.

  • Prenatal vitamins. Prenatal vitamins are prescribed to pregnant women to help meet the extra nutritional needs of pregnancy. When used at the recommended dose, they don’t increase the risk for birth defects. But don’t take any extra vitamins, minerals, or herbal supplements without talking with your healthcare provider first. Extra amounts may be harmful.

  • Microwave ovens. Microwave ovens use nonionizing radiation. This type of radiation is not teratogenic. Microwaving food while pregnant is not known to increase the risk for birth defects or health problems.

Talking with your healthcare provider

If you’re pregnant, talk with your healthcare provider about things to avoid during pregnancy that may cause birth defects. They can answer your questions and help you have a safe pregnancy.

How does teratogens affect prenatal development?

Teratogens may affect the embryo or fetus in a number of ways, causing physical malformations, problems in the behavioral or emotional development of the child, and decreased intellectual quotient (IQ) in the child.

What are the most common teratogens affecting prenatal development?

Common teratogens include some medications, recreational drugs, tobacco products, chemicals, alcohol, certain infections, and in some cases, uncontrolled health problems in the birthing parent. Alcohol is a well-known teratogen that can cause harmful effects on the fetus after exposure at any time during pregnancy.

What are teratogens and how can they negatively impact prenatal development?

A teratogen is a substance that interferes with normal fetal development and causes congenital disabilities. Drugs, alcohol, chemicals and toxic substances are examples of teratogens. Teratogens can also increase the risk for miscarriage, preterm labor or stillbirth.

What are the three factors that impact the effect of teratogens?

The impact of teratogens on pregnancy or a fetus depends on several factors. The timing and length of exposure, the stage of pregnancy when the exposure happened, whether a parent's genes make them more susceptible, and the type of agent they were exposed to all contribute to the risk.