The physician's role in prenatal counseling.

Malformations occur in 3 percent of all live-born infants in the United States. A successful effort to reduce this incidence depends on understanding the factors that cause malformations and taking steps to eliminate them. Often these steps must be taken before conception, and the responsibility falls on the physician who regularly sees the patient. The patient's history and the acronym DIRE --drugs, infections, radiation and environment--are useful in assessing reproductive risk.