Robertson Julia, Polifka Janine E, Avner Marina, Chambers Christina, Delevan George, Koren Gideon, Lavigne Sharon Voyer, Martinez Lynn P, Miller Richard K, Carey John C
Utah Department of Health, Division of Community and Family Health Services, Birth Defects and Genetics Program, Pregnancy RiskLine, Salt Lake City, 84114-4691, USA.
Birth Defects Res A Clin Mol Teratol. 2005 Nov;73(11):881-7. doi: 10.1002/bdra.20197.
Isotretinoin is a known human teratogen, causing birth defects and/or subnormal cognitive performance in prenatally-exposed children.
A survey was conducted among women who called teratology information services throughout North America. Using a structured questionnaire, women with an isotretinoin-exposed pregnancy were prospectively interviewed before the outcome of the pregnancy was known.
Almost 1/4 of the women surveyed (24%; 8/34) did not recall having contraception counseling before starting their medications. Once therapy was initiated, 62% (21/34) recalled using a birth control method, but only 29% (6/21) recalled using 2 forms of birth control, as specified by the voluntary pregnancy prevention programs. Monthly pregnancy tests were not always conducted during treatment, as recalled by the surveyed women (56%; 19/34). As many as 24% (8/34) of the women surveyed recalled that they were not screened using 2 pregnancy tests before receiving a prescription, another recommendation of the programs. Only a small number of the women (30%; 6/20) in the United States recalled being enrolled in any manufacturers' voluntary pregnancy prevention survey.
Results demonstrate that essential components of voluntary pregnancy prevention programs were not consistently followed, which resulted in fetal exposures.
异维甲酸是一种已知的人类致畸剂，会导致产前接触该药物的儿童出现出生缺陷和/或认知能力低于正常水平。
对北美各地致电致畸学信息服务机构的女性进行了一项调查。使用结构化问卷，在妊娠结果知晓之前，对有过异维甲酸暴露妊娠的女性进行前瞻性访谈。
近四分之一接受调查的女性（24%；8/34）不记得在开始用药前接受过避孕咨询。一旦开始治疗，62%（21/34）的女性记得使用了避孕方法，但只有29%（6/21）的女性记得按照自愿妊娠预防计划的规定使用了两种避孕方式。如接受调查的女性所回忆，治疗期间并非总是每月进行妊娠检测（56%；19/34）。多达24%（8/34）接受调查的女性回忆说，她们在获得处方前未按照该计划的另一项建议接受两次妊娠检测。在美国，只有少数女性（30%；6/20）记得参加过任何制造商的自愿妊娠预防调查。
结果表明，自愿妊娠预防计划的基本组成部分未得到始终如一的遵循，从而导致了胎儿暴露。
