Fetal Drug Exposure—Behavioral Teratogenesis

Abstract

This paper reviews the neurobehavioral and developmental effects of fetal drug exposure. The drugs most commonly associated with adverse developmental outcome include alcohol, anticonvulsants (particularly phenytoin and trimethadione), narcotics, and some environmental toxins. Major limitations of studies examining the consequences of prenatal drug exposure on development include inadequate control of other confounding factors, uncertain accuracy of drug histories, and outcome criteria that provide insufficient delineation of subtle developmental delays.

Minor Physical Anomalies in Schizophrenia and Mood Disorders

“…Evidence suggests that some cases of schizophrenia are associated with abnormal prenatal development (Parnas et al 1982; Gal and Sharpless 1984; Mednick et al 1988; Bracha et al 1991; O’Callaghan et al 1991). For example, in a study by Parnas et al (1982), pregnancy and birth complications were associated with the development of schizophrenia, whereas patients with borderline schizophrenia (a diagnosis corresponding to schizotypal personality disorder) had no such difficulties in their birth histories.…”

Facial clefts and congenital heart defects in children of parents with epilepsy: genetic and environmental etiologic factors

“…Reduced birthweight and slight microcephaly following carbamazepine exposure in early pregnancy have been reported (Hiilesmaa et al, 1981;Kuhnz et al, 1983), but the importance and implications for postnatal physical and intellectual development have not yet been settled. It must be stressed that the important field of neurobehavioral effects of fetal AED exposure or behavioral teratogenesis needs extensive exploration (Steinhausen et al, 1982;Gal & Sharpless, 1984). Teratogenicity of metabolites of antiepileptic drugs Many AED, including carbamazepine and valproic acid, have potentially teratogenic metabolites.…”

Can Schizophrenia Be Related to Prenatal Exposure to Alcohol? Some Speculations

“…Some signs of central nervous system dysfunction in FAS may not become apparent until the child must use higher intellectual processes in an academic setting (Shaywitz et al 1980). In its ability to produce behavioral abnormalities, alcohol appears to be able to cause harm to the fetus even when consumed in small amounts (Gal and Sharpless 1984). Many of the behavioral problems noted in children with FAS, including attentional impairment and motor and sensorimotor abnormalities, have also been described in children at risk for developing schizophrenia (MacCrimmon et al 1980; Marcus et al 1981; Watt et al 1984).…”