The three most common occupational exposures reported by pregnant women: an update

Article Abstract:

Studies in animals and man have shown that exposure to industrial chemicals can have adverse effects on reproduction. Drugs used to treat human disease are routinely tested for possible teratogenic effects (toxic effects on fetal growth and development) before they are marketed. However, industrial chemicals are not normally tested for their ability to cause teratogenic effects. In addition, persons may be exposed to more than one chemical or to an unknown chemical by-product in the industrial setting. The amount of chemical absorbed through the skin may be difficult to determine, and the degree of exposure varies among industrial plants. Although the amount of some chemical to which a worker can be safely exposed is limited, safety regulations for industrial chemical exposure have not been developed to protect the fetus. The Motherisk program in Toronto, Canada is a counseling service for pregnant women that provides recommendations concerning the prevention or reduction of exposure to drugs, chemicals, and infection during pregnancy and breastfeeding. This counseling program has developed an approach to dealing with occupational exposure of pregnant women. The three most common types of exposure in the workplace are described, and include video display terminals, organic solvents, and lead. Studies show that exposure to video display terminals do not pose a reproductive hazard. Exposure to organic solvents may cause birth-related defects and complications of pregnancy, but this is difficult to measure or demonstrate. Although intoxication of the mother with solvents is known to have toxic effects on the fetus, the teratogenic effects of specific organic solvents that are not toxic to the mother have not been extensively studied. There is no evidence to show that exposure to organic solvents within the workplace, that are within safety limits, cause toxic effects to the fetus. Exposure to lead has adverse effects on reproduction and the degree to which the fetus has been exposed to lead can be determined and treated. Recent studies show that lead levels in the mother that are even lower than the accepted adult limits may have adverse effects on the fetus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Occupational diseases, Prenatal influences, Industrial toxicology, Teratogenesis

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Initiation and duration of breast-feeding in women receiving antiepileptics

Article Abstract:

Women taking antiepileptic medication seem less likely to breastfeed and breastfeed for a shorter duration despite consensus among neurologists that, with the exception of sedative medications, antiepileptic drugs are safe for breastfed babies. Thirty-four pregnant epileptic women attending the Motherisk clinic in Toronto, Canada were matched with 34 women who were not taking antiepileptic medication. Women were subsequently interviewed about feeding choices. Fifty percent of the epileptic women chose to breastfeed versus 85% of control women. Epileptic women who breastfed weaned the baby by five months on average versus 9 months on average among control women. No infant had an adverse reaction to its mother's antiepileptic medication. Forty-one percent of epileptic women reported that their doctor either recommended against breastfeeding or were equivocal. Given the many benefits of breastfeeding, efforts should be made to encourage breastfeeding among epileptic women. As a precaution, the baby should be monitored for adverse reactions.

Breast feeding, Anticonvulsants

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Pregnancy outcome after gestational exposure to amiodarone in Canada

Article Abstract:

Fetal exposure to amiodarone appears to be associated with fetal and neonatal complications. Amiodarone is used to treat life-threatening heart arrhythmias. Researchers followed 12 pregnant women who were taking amiodarone. Among six infants exposed during the first trimester, one had abnormal neurologic signs, one had an overactive thyroid and one had an underactive thyroid. Thyroid abnormality was temporary in both cases. One infant exposed from gestational week 20 had abnormal neuromuscular symptoms. Four infants who were also exposed to beta-blockers were small-for-gestational-age, although growth retardation could also result from the underlying maternal heart disease. Three fetuses experienced episodes of abnormally slow heart rate, including one exposed to beta-blockers. Despite these complications, amiodarone is the best choice for life-threatening arrhythmias.

Fetus, Drug therapy, Arrhythmia, Amiodarone

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