0
Editorial |

Drugs in Pregnancy:  Associations, Causation, and Misperceptions

Gideon Koren, MD; Irena Nulman, MD
Arch Pediatr Adolesc Med. 2010;164(5):494-495. doi:10.1001/archpediatrics.2010.64.
Text Size: A A A
Published online

Extract

Since the thalidomide era, there are concerns regarding potential adverse effects of drug and chemical exposure on the developing fetus in pregnancy, causing physicians and expectant mothers high levels of anxiety toward drugs, even in life-threatening conditions.1 Two articles in this issue of the Archives deal with potential intrauterine effects of xenobiotics and their complex interactions with maternal health and lifestyle. The 2 articles focus on compounds that are at the eye of the storm of current concerns. Oberlander et al2 focus on depression and antidepressants, involving an estimated 10% to 15% of pregnant women, while Stone and colleagues3 deal with potential adverse effects of recreational drugs, used by a substantial proportion of women of reproductive age. While it does not appear that the selective serotonin and epinephrine reuptake inhibitors cause consistent patterns of birth defects,4 there remain concerns regarding the ability of these receptor-specific agents to adversely affect fetal brain development. In general, existing studies have failed to show long-term effects on neurodevelopment, but their interpretation is challenged by the fact that depression and anxiety by themselves are known to adversely affect the child. In a similar manner, while a large number of children are exposed in utero to recreational drugs, on balance, epidemiological studies have failed to show consistent adverse fetal effects of cocaine, methamphetamine, and cannabis.5

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();