Protection Against Antibiotic Teratogens: Steps toward a healthy pregnancy

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TERATOGENS

The word teratogen is a combination of the Greek prefix “teras”, meaning monster and the suffix “gen”, meaning origin. Teratogens are agents or factors that can cause birth defects in a developing embryo.1

Roughly 1 in 33 babies in the United States (120,000 babies) are born with birth defects each year. Birth defects can be caused by either genetic or environmental factors. Teratogens are an example of environmental factors of birth defects, and general teratogens include alcohol use while pregnant, specific drugs, medications, and chemicals, as well as certain infections. Birth defects come in various forms and varying severity. Congenital malformations include malformations of the limbs, heart, or neural system. Other teratogenic effects include mental retardation, intrauterine growth retardation (low weight), miscarriages.2

Many teratogenic birth defects are preventable. The following principles, first adapted by James Wilson, highlight the nature of teratogens:

Principle 1: Susceptibility to teratogenesis depends on the genotype of the embryo

Principle 2: Susceptibility to a teratogenic agent depends on the developmental stage when the exposure occurs

Principle 3: Different teratogenic agents effect developing cells and tissues in various ways

Principle 4: The final manifestations of abnormal development are death, malformation, growth retardation, and functional disorder

Principle 5: The nature of the detrimental environmental agent impacts its access to the fetus.

Principle 6: As dosage increases the manifestations of abnormal development increase in degree from the no-effect to the lethal level

These principles are detailed by R. H. Finnell in Teratology: General considerations and principles.3

Focusing specifically on the effect of antibiotics on embryos, different medications lead to various detrimental outcomes.

- Trimethoprim

- Isotretinoin

- Sexually Transmitted Diseases

- Use of Antibiotics during Pregnancy

- Streptomycin and Tetracyclines

- Sulfonamides

- Ciprofloxacin and Clarithromycin

- Quinolones

REFERENCES:

1Teratogens. (1989). Retrieved September 28, 2007, from Oxford English Dictionary.

2March of Dimes. (2006). Quick References and Fact Sheets: Birth Defects. Retrieved September

30, 2007, from http://www.marchofdimes.com/pnhec/4439_1206.asp

3 Finnell, R.H. (1999). Teratology: General consideration and principles. Journal of Allergy and Clinical Immunology, 103, 337-342.

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