Perception of teratogenic risk by pregnant women exposed to drugs and chemicals during the first trimester

Psychosocial Outcomes Are Related to Asthma Control and Quality of Life in Pregnant Women with Asthma

“…However, they inaccurately identified a teratogenic risk associated with ICS and β2-agonist use and overestimated the magnitude of teratogenic effects for all classes of asthma drugs. Overestimation of teratogenic effects has been observed in other situations (32,34). In this study, women significantly overestimated the teratogenic effects of OCS.…”

The over-estimation of risk in pregnancy

“…While the baseline risk is less than 5%, the women's estimation of risk from non-teratogenic influences was often around 25% -the same as the risk of limb reduction defects in pregnancies exposed to thalidomide [16,17]. Not only that, while physicians tended to be closer to the mark, they also overestimated the risk of non-teratogenic substances [17].…”

“…There are more serious consequences as well. The mistaken belief that teratogenic exposure has occurred could, in some circumstances, lead women to consider or seek termination of otherwise wanted and healthy pregnancies [16,50]. The end result is that the focus on prenatal risk and efforts to avoid pre-natal risk exposure based on heightened risk perception could potentially be doing more harm than the feared risk itself [50].…”

“…Another example of inflated perceptions of risk comes from the work of Koren et al [16], who found that pregnant women tend to assign an unreasonably high risk to non-teratogenic medications and grossly over-estimate their risk after exposure to such medicines. While the baseline risk is less than 5%, the women's estimation of risk from non-teratogenic influences was often around 25% -the same as the risk of limb reduction defects in pregnancies exposed to thalidomide [16,17].…”

“…Considered to be the 'prototype teratogen', the drug thalidomide was marketed in 46 countries in the late 1950s and early 1960s [16]. It was prescribed to pregnant women as a treatment for nausea and vomiting (hyperemesis) before being withdrawn in 1962 following the discovery that it was responsible for serious congenital abnormalities (notably severe limb defects, organ dysgenesis) and increased rates of miscarriage [22][23][24].…”