Teratojenler
Synopsis
Gebeliğin herhangi bir aşamasında, fetüsün gelişimini olumsuz etkileyerek doğuştan anomalilere (konjenital malformasyonlara) yol açabilen çeşitli etkenlerdir. Kimyasallar, alkol, sigara, bazı enfeksiyonlar ve radyasyon teratojenlere örnek olarak verilebilir. Gebeliğin ilk üç ayı, organların ve dokuların oluştuğu kritik bir dönem olduğundan teratojenlere karşı en hassas dönemdir. Teratojenlerin etkisi, maruziyetin zamanlamasına, dozuna ve annenin genel sağlık durumuna bağlı olarak değişir. Gebelikte teratojenlerden kaçınmak ve gerekli durumlarda tıbbi yardım almak, konjenital malformasyon riskini azaltmak için önemlidir.
Teratogens are various factors that can affect the development of the foetus at any stage of pregnancy, resulting in congenital malformations. Examples of teratogens include chemicals, alcohol, smoking, certain infections and radiation. The first trimester of pregnancy is the most vulnerable to teratogens because it is a critical period when organs and tissues are being formed. The effects of teratogens vary depending on the time and dose of exposure and the general health of the mother. It is important to avoid teratogens during pregnancy and to seek medical advice if necessary to reduce the risk of congenital malformations.
References
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Einarson A, Boskovic R. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract. 2009 May;15(3):183–92.
Thorpe PG, Gilboa SM, Hernandez-Diaz S, Lind J, Cragan JD, Briggs G, et al. Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk. Pharmacoepidemiol Drug Saf. 2013 Sep;22(9):1013–8.
Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet C Semin Med Genet. 2011 Aug;157C(3):175–82.
Sahin L, Nallani SC, Tassinari MS. Medication use in pregnancy and the pregnancy and lactation labeling rule. Clin Pharmacol Ther. 2016;100(1):23–5.
Vargesson N, Stephens T. Thalidomide: history, withdrawal, renaissance, and safety concerns. Vol. 20, Expert opinion on drug safety. England; 2021. p. 1455–7.
Reis M, Källén B. Maternal use of antipsychotics in early pregnancy and delivery outcome. J Clin Psychopharmacol. 2008 Jun;28(3):279–88.
Altshuler LL, Cohen L, Szuba MP, Burt VK, Gitlin M, Mintz J. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry. 1996 May;153(5):592–606.
Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, et al. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry. 2004 Apr;161(4):608–20.
Fornaro M, Maritan E, Ferranti R, Zaninotto L, Miola A, Anastasia A, et al. Lithium Exposure During Pregnancy and the Postpartum Period: A Systematic Review and Meta-Analysis of Safety and Efficacy Outcomes. Am J Psychiatry. 2020 Jan;177(1):76–92.
Lebin LG, Novick AM. Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child. Curr Psychiatry Rep. 2022 Nov;24(11):687–95.
Acar S, Erol H, Arslan EK, Uysal N, Karadaş B, Temiz TK, et al. Paroxetine overdose during pregnancy. Vol. 6, Forensic sciences research. England; 2021. p. 237–9.
Lammer EJ, Chen DT, Hoar RM, Agnish ND, Benke PJ, Braun JT, et al. Retinoic acid embryopathy. N Engl J Med. 1985 Oct;313(14):837–41.
Geiger J-M, Baudin M, Saurat J-H. Teratogenic risk with etretinate and acitretin treatment. Dermatology. 1994;189(2):109–16.
Rozance PJ, Wright CJ, Landon MB, Galan HL, Jauniaux ERM. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 2020;
Duck SC, Katayama KP. Danazol may cause female pseudohermaphroditism. Fertil Steril. 1981;35(2):230–1.
Menger H, Lin AE, Toriello H V, Bernert G, Spranger JW. Vitamin K deficiency embryopathy: a phenocopy of the warfarin embryopathy due to a disorder of embryonic vitamin K metabolism. Am J Med Genet. 1997;72(2):129–34.
Laube GF, Kemper MJ, Schubiger G, Neuhaus TJ. Angiotensin-converting enzyme inhibitor fetopathy: long-term outcome. Arch Dis Child - Fetal Neonatal Ed. 2007;92(5):F402--F403.
Hoeltzenbein M, Elefant E, Vial T, Finkel‐Pekarsky V, Stephens S, Clementi M, et al. Teratogenicity of mycophenolate confirmed in a prospective study of the European Network of Teratology Information Services. Am J Med Genet Part A. 2012;158(3):588–96.
Hyoun SC, Običan SG, Scialli AR. Teratogen update: methotrexate. Birth Defects Res Part A Clin Mol Teratol. 2012;94(4):187–207.
Czeizel AE, Rockenbauer M. Population‐based case‐control study of teratogenic potential of corticosteroids. Teratology. 1997;56(5):335–40.
Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006;107(5):1120–38.
Czeizel AE, Rockenbauer M. A population-based case-control teratologic study of oral oxytetracycline treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2000;88(1):27–33.
Liu D, Zhang C, Wu L, Zhang L, Zhang L. Fetal outcomes after maternal exposure to oral antifungal agents during pregnancy: A systematic review and meta‐analysis. Int J Gynecol Obstet. 2020;148(1):6–13.
Ericson A, Källén BAJ. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol. 2001;15(4):371–5.
Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, et al. Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. Jama. 2021;325(3):265–79.
Martínez‐Frías ML, Czeizel AE, Rodriguez‐Pinilla E, Bermejo E. Smoking during pregnancy and Poland sequence: Results of a population‐based registry and a case‐control registry. Teratology. 1999;59(1):35–8.
Streissguth AP, Landesman-Dwyer S, Martin JC, Smith DW. Teratogenic effects of alcohol in humans and laboratory animals. Science (80- ). 1980;209(4454):353–61.
Snodgrass SR. Cocaine babies: A result of multiple teratogenic influences. J Child Neurol. 1994;9(3):227–33.
Orsolini L, Papanti D, Corkery J, De Luca MA, Cadoni C, Di Chiara G, et al. Is there a teratogenicity risk associated with cannabis and synthetic cannabimimetics’(‘spice’) intake? CNS Neurol Disord Targets (Formerly Curr Drug Targets-CNS Neurol Disord. 2017;16(5):585–91.
Brent RL. The Effects of Embryonic and Fetal Exposure to X-ray, Microwaves, and Ultrasound. Clin Perinatol. 1986;13(3):615–48.
Adelstein SJ. Administered radionuclides in pregnancy. Teratology. 1999;59(4):236–9.
Mobarak Y. Review of the developmental toxicity and teratogenicity of three environmental contaminants (cadmium, lead and mercury). Catrina Int J Environ Sci. 2008;3(1):31–43.
Bellinger DC. Teratogen update: lead and pregnancy. Birth Defects Res Part A Clin Mol Teratol. 2005;73(6):409–20.
Einarson A, Boskovic R. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract. 2009 May;15(3):183–92.
Thorpe PG, Gilboa SM, Hernandez-Diaz S, Lind J, Cragan JD, Briggs G, et al. Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk. Pharmacoepidemiol Drug Saf. 2013 Sep;22(9):1013–8.
Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet C Semin Med Genet. 2011 Aug;157C(3):175–82.
Sahin L, Nallani SC, Tassinari MS. Medication use in pregnancy and the pregnancy and lactation labeling rule. Clin Pharmacol Ther. 2016;100(1):23–5.
Vargesson N, Stephens T. Thalidomide: history, withdrawal, renaissance, and safety concerns. Vol. 20, Expert opinion on drug safety. England; 2021. p. 1455–7.
Reis M, Källén B. Maternal use of antipsychotics in early pregnancy and delivery outcome. J Clin Psychopharmacol. 2008 Jun;28(3):279–88.
Altshuler LL, Cohen L, Szuba MP, Burt VK, Gitlin M, Mintz J. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry. 1996 May;153(5):592–606.
Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, et al. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry. 2004 Apr;161(4):608–20.
Fornaro M, Maritan E, Ferranti R, Zaninotto L, Miola A, Anastasia A, et al. Lithium Exposure During Pregnancy and the Postpartum Period: A Systematic Review and Meta-Analysis of Safety and Efficacy Outcomes. Am J Psychiatry. 2020 Jan;177(1):76–92.
Lebin LG, Novick AM. Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child. Curr Psychiatry Rep. 2022 Nov;24(11):687–95.
Acar S, Erol H, Arslan EK, Uysal N, Karadaş B, Temiz TK, et al. Paroxetine overdose during pregnancy. Vol. 6, Forensic sciences research. England; 2021. p. 237–9.
Lammer EJ, Chen DT, Hoar RM, Agnish ND, Benke PJ, Braun JT, et al. Retinoic acid embryopathy. N Engl J Med. 1985 Oct;313(14):837–41.
Geiger J-M, Baudin M, Saurat J-H. Teratogenic risk with etretinate and acitretin treatment. Dermatology. 1994;189(2):109–16.
Rozance PJ, Wright CJ, Landon MB, Galan HL, Jauniaux ERM. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 2020;
Duck SC, Katayama KP. Danazol may cause female pseudohermaphroditism. Fertil Steril. 1981;35(2):230–1.
Menger H, Lin AE, Toriello H V, Bernert G, Spranger JW. Vitamin K deficiency embryopathy: a phenocopy of the warfarin embryopathy due to a disorder of embryonic vitamin K metabolism. Am J Med Genet. 1997;72(2):129–34.
Laube GF, Kemper MJ, Schubiger G, Neuhaus TJ. Angiotensin-converting enzyme inhibitor fetopathy: long-term outcome. Arch Dis Child - Fetal Neonatal Ed. 2007;92(5):F402--F403.
Hoeltzenbein M, Elefant E, Vial T, Finkel‐Pekarsky V, Stephens S, Clementi M, et al. Teratogenicity of mycophenolate confirmed in a prospective study of the European Network of Teratology Information Services. Am J Med Genet Part A. 2012;158(3):588–96.
Hyoun SC, Običan SG, Scialli AR. Teratogen update: methotrexate. Birth Defects Res Part A Clin Mol Teratol. 2012;94(4):187–207.
Czeizel AE, Rockenbauer M. Population‐based case‐control study of teratogenic potential of corticosteroids. Teratology. 1997;56(5):335–40.
Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006;107(5):1120–38.
Czeizel AE, Rockenbauer M. A population-based case-control teratologic study of oral oxytetracycline treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2000;88(1):27–33.
Liu D, Zhang C, Wu L, Zhang L, Zhang L. Fetal outcomes after maternal exposure to oral antifungal agents during pregnancy: A systematic review and meta‐analysis. Int J Gynecol Obstet. 2020;148(1):6–13.
Ericson A, Källén BAJ. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol. 2001;15(4):371–5.
Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, et al. Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. Jama. 2021;325(3):265–79.
Martínez‐Frías ML, Czeizel AE, Rodriguez‐Pinilla E, Bermejo E. Smoking during pregnancy and Poland sequence: Results of a population‐based registry and a case‐control registry. Teratology. 1999;59(1):35–8.
Streissguth AP, Landesman-Dwyer S, Martin JC, Smith DW. Teratogenic effects of alcohol in humans and laboratory animals. Science (80- ). 1980;209(4454):353–61.
Snodgrass SR. Cocaine babies: A result of multiple teratogenic influences. J Child Neurol. 1994;9(3):227–33.
Orsolini L, Papanti D, Corkery J, De Luca MA, Cadoni C, Di Chiara G, et al. Is there a teratogenicity risk associated with cannabis and synthetic cannabimimetics’(‘spice’) intake? CNS Neurol Disord Targets (Formerly Curr Drug Targets-CNS Neurol Disord. 2017;16(5):585–91.
Brent RL. The Effects of Embryonic and Fetal Exposure to X-ray, Microwaves, and Ultrasound. Clin Perinatol. 1986;13(3):615–48.
Adelstein SJ. Administered radionuclides in pregnancy. Teratology. 1999;59(4):236–9.
Mobarak Y. Review of the developmental toxicity and teratogenicity of three environmental contaminants (cadmium, lead and mercury). Catrina Int J Environ Sci. 2008;3(1):31–43.
Bellinger DC. Teratogen update: lead and pregnancy. Birth Defects Res Part A Clin Mol Teratol. 2005;73(6):409–20.
Pages
113-128
Published
April 29, 2024
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1.
Avan M. Teratojenler. In: Demir SC, editor. Güncel Kadın Hastalıkları ve Doğum Çalışmaları VII (Bahar) [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2024 [cited 2026 Jul. 13]. pp. 113-28. Available from: https://www.omp35.books.akademisyen.net/index.php/akya/catalog/book/3066/chapter/13410
