De Santis Marco, Cesari Elena, Ligato Maria Serena, Nobili Elena, Straface Gianluca, Cavaliere Annafranca, Caruso Alessandro
Telefono Rosso-Teratology Information Service, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Med Sci Monit. 2008 Feb;14(2):PH1-8.
Concern about exposure to drugs, radiation, or infection during pregnancy occur often because pregnancy is not always planned. A teratology information service offers rapid scientific counseling to all those worried about prenatal exposure. The aim of this study is to present data on the most common pharmaceutical products responsible for teratogenic risk in the one-year experience of a teratology information service in Italy.
MATERIAL/METHODS: The survey was conducted among 8664 callers who contacted our Teratology Information Service in Rome between January and December 2006. Data on maternal age, gravidity, parity, maternal health status, and details of exposure (dose and timing) were collected and stored in a specific data base. Scientific counseling on prenatal exposure was given to the caller by a specialized service operator, specifying the type of risk and suggesting appropriate tests for prenatal diagnosis.
Most of the people called regarding drug exposure; increased risk was present in only 5% of the pregnant women calling during pregnancy. Selective serotonin reuptake inhibitors (SSRIs) are the first category that are actually considered of increased risk to the fetus. The second category is represented by antiepileptic drugs.
This experience confirms previous data that there is a high teratological risk perception among both women and physicians. The drugs estimated to present increased risk are medications used for chronic neurological diseases, mainly mood disorders and epilepsy. Preconceptional counseling for these women could be an effective strategy to prevent such exposure and to improve maternal and fetal outcome.
由于怀孕往往并非计划之中，所以人们常常担心孕期接触药物、辐射或感染。致畸学信息服务为所有担心产前接触这些因素的人提供快速的科学咨询。本研究的目的是呈现意大利一家致畸学信息服务机构一年经验中，导致致畸风险的最常见药品的数据。
材料/方法：对2006年1月至12月期间联系罗马致畸学信息服务机构的8664名来电者进行了调查。收集了产妇年龄、妊娠次数、产次、产妇健康状况以及接触详情（剂量和时间）的数据，并存储在一个特定数据库中。由专业服务人员向来电者提供关于产前接触的科学咨询，明确风险类型并建议进行适当的产前诊断检测。
大多数来电是关于药物接触；在孕期来电的孕妇中，只有5%存在风险增加的情况。选择性5-羟色胺再摄取抑制剂（SSRIs）是实际被认为对胎儿风险增加的第一类药物。第二类是以抗癫痫药物为代表。
这一经验证实了先前的数据，即女性和医生对致畸风险的认知都很高。估计存在风险增加的药物是用于慢性神经疾病的药物，主要是情绪障碍和癫痫药物。对这些女性进行孕前咨询可能是预防此类接触并改善母婴结局的有效策略。
