Brenda Debus and Lori Wolfe are teratogen counselors at the Texas Teratogen
Information Service/Pregnancy Riskline in Denton, Texas. Brenda Debus has a
master’s degree in Counseling Psychology, and Lori Wolfe has a master’s
degree in Genetic Counseling and has been the Director of the teratogen
service for 17 years. They conduct free phone counseling for women and their
health-care providers with questions about exposures related to their
pregnancies and breastfeeding. They have prepared this basic guide on
Teratogens for readers of MetroplexBaby.com.
TERATOGENS AND THEIR EFFECTS ON UNBORN &
What is a “teratogen”? •
my risk of having a baby born with a birth defect?
What are the chances that I will miscarry during my pregnancy?
is a “teratogen”?
A “teratogen” is any exposure that can cause harm to an
unborn or breastfeeding baby. Teratogens can be alcohol,
prescription/non-prescription medications, illegal drugs,
vaccines, illnesses, environmental exposures, occupational
exposures, or maternal autoimmune disorders.
What is my risk of having a
baby born with a birth defect?
Every woman has a 3-5% risk of having a baby born with a
birth defect. Some teratogens will increase that risk,
depending upon when in the pregnancy a woman has the
exposure, the dose of the exposure, and the route of
What are the chances that I
will miscarry during my pregnancy?
We know that 25% of all recognized pregnancies end in
miscarriage. The risk of a miscarriage drops to 10% in your
eighth week. Some teratogens will increase this risk, but it
is dependent upon the type and amount of the exposure as
well as the timing in the pregnancy.
Following is a list of some
common exposures for which we are called:
Depending upon the amount of alcohol you consume, the risk
of miscarriage and birth defects vary. A small to moderate
amount (2-4 drinks frequently) can lead to “Fetal Alcohol
Effect,” which increases the risk of miscarriage,
developmental delay, and hyperactivity in the child. Heavy
use of alcohol (5-6 drinks frequently) can lead to “Fetal
Alcohol Syndrome,” where the risk of miscarriage is
increased even more, and the baby has a small head size,
facial abnormalities such as small eyes and nose, small
nails, ear abnormalities, heart defects, learning
difficulties, behavioral problems, and mental retardation.
The more a woman smokes, the higher the risk of miscarriage,
stillbirth, low birth weight, premature birth, Sudden Infant
Death Syndrome (SIDS), possible increase in developmental
delays, a 1% risk for cleft palate (a hole in the roof of
the mouth), and failure to thrive. Smoking over ˝ pack of
cigarettes per day or more appears to put your pregnancy in
the increased risk group. It is also important to not allow
anyone to smoke around newborn or young infants.
Accutane is retinoic acid that is given in pill form by
prescription only for severe acne. This medication is
extremely dangerous, as 25-38% of infants exposed in the
first trimester will exhibit abnormalities: hydrocephalus
(excess fluid in the brain), brain defects, mental
retardation, ear/face abnormalities, heart and limb defects,
and chronic skin lesions. There is also an increased risk of
Most antibiotics are safe to take during your pregnancy, but
there are exceptions. Aminoglycosides are used for severe
infections and they have a 2% increased risk for hearing
impairment. Tetracycline and Doxycycline can cause
yellow-brown staining of the teeth when used during the 4th
to 9th month of pregnancy. If this medication is used in the
3rd trimester, there can be decreased fetal bone growth.
This type of antibiotic also should not be used while
With antidepressants, there can be a less than 1% increased
risk for learning difficulties, and possibly mild to
moderate but temporary withdrawal symptoms at birth (the
baby may tend to be more irritable, have problems feeding,
and difficulty in being soothed). There can also be
premature delivery. However, we feel that usually the
benefits to the mother outweigh the risks to the baby.
Studies show that stress can cause a host of other problems
to the baby, and post-partum depression can be worse in
women who suffer from depression.
Using cocaine during pregnancy can increase the risk not
only of miscarriage, but can also lead to premature
detachment of the placenta, a low-birth-weight baby, brain
damage, small head, limb abnormalities, gastro-urinary
abnormalities, heart defects, and infant withdrawal.
If you have any further questions, please contact