Bologa-Campeanu M, Koren G, Rieder M, McGuigan M
Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, Canada.
Med Toxicol Adverse Drug Exp. 1988 Jul-Aug;3(4):307-23. doi: 10.1007/BF03259942.
Using the number of calls to the Canadian Motherisk Program as an indicator of the drugs and chemicals frequently of concern to mothers during pregnancy, the risks to the fetus of exposure to these compounds have been reviewed. The drugs which were of concern, and have been proven to be teratogenic, included alcohol, alkylating and antimetabolite agents, stilboestrol, disulfiram, heparin, lithium carbonate, phenytoin, tretinoin (retinoic acid), troxidone and valproic acid. For other compounds studied, there was either no data in the literature or no clear evidence of teratogenicity. The combination of doxylamine and pyridoxine, for example, has been associated with limb reduction defects in isolated case reports: cohort and case-control studies have failed to show a higher-than-baseline risk of malformations. In some cases of exposure to compounds with no known teratogenic potential, other adverse effects to the fetus are possible, and these effects are discussed in detail. In conclusion, when advising a pregnant woman about the potential teratogenic effect of a particular drug or chemical exposure, the health professional should also discuss other factors such as age, obstetric and medical history and the history of other exposures (including alcohol and smoking). In every pregnancy there is a 1 to 5% risk of mayor malformations, and even if the exposure does not appear to increase the teratogenic risk, such a risk still exists.
以拨打加拿大母亲风险计划热线的次数作为孕期母亲频繁关注的药物和化学品指标，对胎儿接触这些化合物的风险进行了评估。受关注且已被证实具有致畸性的药物包括酒精、烷化剂和抗代谢剂、己烯雌酚、双硫仑、肝素、碳酸锂、苯妥英、维甲酸、曲昔多巴和丙戊酸。对于其他研究的化合物，文献中要么没有数据，要么没有明确的致畸证据。例如，在个别病例报告中，多西拉敏和吡哆醇的组合与肢体减少缺陷有关：队列研究和病例对照研究均未显示出高于基线的畸形风险。在某些接触无已知致畸潜力化合物的情况下，胎儿可能会出现其他不良反应，本文将详细讨论这些影响。总之，在向孕妇告知特定药物或化学物质接触的潜在致畸作用时，健康专业人员还应讨论其他因素，如年龄、产科和病史以及其他接触史（包括酒精和吸烟）。每次怀孕都有1%至5%的严重畸形风险，即使接触似乎不会增加致畸风险，这种风险仍然存在。
