Prevention of unnecessary pregnancy terminations by counselling women on drug, chemical, and radiation exposure during the first trimester

Authors

  • Gideon Koren,

    1. The Motherisk Program, The Division of Clinical Pharmacology, Department of Pediatrics and The Research Institute, The Hospital for Sick Children, and Departments of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario M5G 1X8, Canada
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  • Anne Pastuszak

    1. The Motherisk Program, The Division of Clinical Pharmacology, Department of Pediatrics and The Research Institute, The Hospital for Sick Children, and Departments of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario M5G 1X8, Canada
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Abstract

As part of a new approach to counselling pregnant women concerned about antenatal exposure to drugs, chemicals, or radiation, we measured their tendency to terminate their pregnancy by using a visual analogue scale (VAS). Analysis of 78 cases where women had less than 50% tendency to continue pregnancy before they were advised by us reveals that 61 decided to continue their pregnancy after the consultation (57 normal, healthy infants, four miscarriages) and 17 terminated. Women who continued their pregnancy significantly changed their tendency after we discussed relevant information with them (from 34.3 ± 2.5% to 84.5 ± 3.3%, P<0.00001), whereas most of those who eventually terminated pregnancy did not change their tendency to continue pregnancy beyond the 50% mark (from 24.8 ± 5.4% to 45.1 ± 9.8%) (P>0.1). Only two of the women who terminated their pregnancy were exposed to teratogenic drugs; however, in most other cases, other obvious reasons, unrelated to the exposure in question, were identified by the women as leading reasons for termination.

An appropriate intervention in early pregnancy can prevent unnecessary pregnancy terminations by correcting misinformation and thereby decreasing the unrealistically high perception of risk by women exposed to nonteratogens.

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