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A teratogen is a compound which permanently deforms the function or structure of a developing embryo or fetus.
Differentiate among teratogens that could negatively impact fetal development
The effects of the teratogen on the fetus depend on several factors: potency of the teratogen, susceptibility of the fetus to the teratogen, dose and duration of teratogen exposure, degree of transfer from maternal to fetal circulation, and when during development the exposure occurs.
Approximately 10% of congenital malformations are attributed to environmental factors, and 20% are due to genetic or hereditary factors. The rest have unknown causes or are due to a mix of different factors.
The central nervous and skeletal systems tend to be most affected by teratogens.
Cigarette components, alcohol, cocaine, warfarin, ACE inhibitors, and Accutane are all teratogens that affect fetal development.
A teratogen is a compound which permanently deforms the function or structure of a developing embryo or fetus in utero. In general, the degree of teratogenicity depends on:
potency of the drug as a mutagen
susceptibility of the fetus to teratogenesis
dose of the teratogen
duration of teratogen exposure
time of exposure
degree of transfer from maternal to fetal circulation
The global average of all live births complicated by malformation is 6% (Environmental Health Perspectives, (NIH), October 2009). The majority of these complications are due to unknown factors. The vast majority of recognized etiologies are genetic, with only 10% being attributed to environmental etiologies such as maternal health, infection, and toxicants. In general, the central nervous and skeletal systems are the most affected.
Women may encounter a number of teratogens. Smoking is most likely to cause growth retardation, but has also been implicated in prelabor rupture of the membranes, preterm labor, abruption of the placenta, spontaneous abortion, perinatal morbidity and mortality, and sudden infant death syndrome. Smoking may exert its effects through competitive binding of carbon monoxide with hemoglobin and/or through the various other components found in cigarettes that cause adverse biological effects.
Alcohol use in
pregnancy may result in fetal alcohol ayndrome (FAS). FAS occurs in approximately
1% of all births. Children with FAS present with a flattened and thin upper
lip, small palpebral fissures, epicanthal folds, flattened nasal bridge, and
short nose. They may also exhibit microcephaly, mental retardation, and have
learning disabilities. It is not clear if there is any safe amount of alcohol
consumption in pregnancy.
Cocaine generally produces growth restriction, preterm delivery, microcephaly, spontaneous abortion, placental abruption, limb anomalies, and central nervous system abnormalities. Cocaine appear to exert a number of its effects through peripheral vasoconstriction leading to fetal hypoxia.
Women with indications for warfarin therapy should either abstain from pregnancy or switch to low molecular weight heparins. Warfarin typically produces mental retardation, growth restriction, nasal hypoplasia, and opthalmic abnormalities.
Angiotensin Converting Enzyme (ACE) inhibitors will cause fetal renal failure and oligohydramnios which lead to pulmonary hypoplasia and limb contracture. Fetal cranial bone abnormalities are also common.
Isotretinoin (Accutane), used to treat acne, may cause cardiac, oral, otological, thymic, and central nervous system abnormalities. In one quarter of cases, it causes mental retardation.
Other teratogenic substance classes and conditions
include various prescription drugs and nutrient deficiencies (eg., insufficient
such as methyl iodide (used in pesticides) and Bisphenol A (used in plastics)
are suspected teratogens. Thalidomide
(a sedative previously marketed in Europe to prevent morning sickness) is a classic teratogen that caused limb defects in babies born to women taking this drug in the 1960s.