Birth Injury Resource Center

Dangerous Drugs

Sometimes birth injuries or birth defects occur as a result of a prescription drug or other medication taken by the mother before or during pregnancy. The term teratogen is used to describe any agent that affects the normal, healthy development of an embryo or fetus.

Teratogens can affect an embryo as early as ten to 14 days after conception. Since organs and limbs develop during the first trimester of pregnancy, exposure during this time is especially dangerous. However, some fetal organ systems, such as the central nervous system, are vulnerable to teratogen exposure throughout the entire pregnancy.

What Drugs Can Cause Birth Injuries?

Below is a list of some medications that have been linked to serious birth injuries when used during pregnancy. For many women, the benefits of taking certain drugs during pregnancy may outweigh their risks. Only a licensed medical provider can make this determination.

• Paxil (Paroxetine). Paroxetine belongs to a class of drugs called SSRIs (Selective Serotonin Reuptake Inhibitors) and is used to treat mental disorders such as depression, anxiety and obsessive-compulsive disorder (OCD). Paroxetine has been associated with a serious lung condition called primary pulmonary hypertension (PPH) in newborns whose mothers took the drug during pregnancy. It has also been linked to an increased risk of heart-related birth injuries.
• Accutane (Isotretinoin). Isotretinoin is a prescription drug used to treat severe cases of acne. When taken by a woman during pregnancy, this medication has been found to cause serious birth defects affecting the baby's skull, heart, brain and eyes.
• ACE Inhibitors, including benazepril (brand name: Lotensin), captopril (brand name: Capoten) and others. ACE (Angiotensin Converting Enzyme) inhibitors describe a class of drugs that help to lower blood pressure. Use of these medications during the first trimester of pregnancy has been linked with malformations of the fetal heart and central nervous system.
• Diethylstilbestrol (DES). Diethylstilbestrol, a synthetic hormone, was given to millions of pregnant women in the U.S. between 1938 and 1971. While the drug was originally thought to prevent miscarriage and premature birth, it is today associated with numerous health problems for both mother and child. Up to one-third of daughters born to women who took DES have an increased risk of infertility, miscarriage or premature birth. Sons of women who used DES also have a greater risk of problems relating to their reproductive tract.
• Tegison (Etretinate). Used to treat serious psoriasis, etretinate has been linked to birth defects in infants of mothers who use it during pregnancy. The drug has since been taken off the market in the United States.
• Terbutaline sulfate (brand names: Brethine, Bricanyl or Brethaire). Terbutaline sulfate is a prescription drug used to treat asthma. Its use during pregnancy has been associated with a higher risk of brain injuries, developmental delays and autism in infants.
• Dilantin (Phenytoin). Phenytoin is a prescription drug that is used to treat epilepsy. It belongs to a class of medications called anticonvulsants, many of which have been found to be unsafe during pregnancy. If used by the mother during her first trimester of pregnancy, phenytoin can cause birth injuries such as cleft palate, developmental delays, and heart defects. The drug has also been linked with a condition called Fetal Hydantoin Syndrome, which refers to a group of birth defects present in a newborn infant.
• Lithium (brand name: Lithobid). Lithium is commonly used to treat bipolar disorder and other depressive conditions. Use of this drug during pregnancy, particularly during the first trimester, has been associated with an increased risk of heart abnormalities and goiter, an enlargement of the thyroid gland.
• Antibiotics. Antibiotics are medications used to treat a wide range of bacterial infections. When taken by the mother while pregnant, the antibiotics tetracycline (brand names: Achromycin, Sumycin) and doxycycline (brand name: Vibramycin) have been found to have serious effects on fetal bone development.
• Penicillamine (brand names: Cuprimine, Depen). Penicillamine is an immunosuppressive drug that is used to treat rheumatoid arthritis and scleroderma. Its use during pregnancy has been linked to birth defects.
• Warfarin (brand name: Coumadin). Warfarin is an oral anticoagulant that is used to treat heart disease. Anticoagulant medications, which slow blood clotting, have been linked with mental retardation, facial deformations and fetal bleeding when taken by the mother during early pregnancy.

Resources

• Lucile Packard Children's Hospital: Medical Genetics - What is Phenytoin (Dilantin)?
• MedicineNet: Definition of Drugs during pregnancy, dangerous
• American Council for Drug Education's: DRUGS AND PREGNANCY
• FamilyDoctor.org: Diethylstilbestrol
• WebMD: ACE Inhibitors May Boost Birth Defects
• MedicineNet.com: Definition of Teratogen