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004: Common Teratogens in Pregnancy

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Teratogens are substances that can cause harm in a developing fetus resulting in birth defects or fetal death. Teratogens affect growth and development of the baby. The effect of the teratogen depends on the specific substance and how much exposure has occurred. Common teratogens include alcohol, tobacco, illegal drugs and medications.
Alcohol should be avoided in pregnancy. The effect on the baby depends on how much alcohol is consumed. In early pregnancy excessive alcohol can cause miscarriage or premature labor. Exposure to alcohol throughout pregnancy can cause mental retardation resulting in a condition know as fetal alcohol syndrome.  These babies are born with both mental and physical ailments.

If you have an alcohol problem it is important to talk to your health care provider. It is important to be honest about how much alcohol you are consuming. Remember no amount of alcohol is safe in pregnancy.


Tobacco use in pregnancy can cause your baby to have problems growing. Smoking causes blood vessels to constrict causing the baby to receive less nutrients and less blood supply. Over time this leads to growth restriction. Women who smoke in pregnancy are more likely to have abnormal pregnancies that result in stillbirths or low weight babies. Please try to quit smoking before you get pregnant and if you cannot, speak to your health care provider about tips on how you can stop. There may be support groups available in your area.

Illegal drug use in pregnancy can lead to major problems in your developing baby. Among these drugs is marijuana, meth-amphetamines  heroin, cocaine, LSD, prescription medications and inhalants. Marijuana can cause similar problems as tobacco. Low birth weight and problems during delivery are common. Problems feeding, sucking, and developmental delay have also occurred.

Methamphetamines and cocaine have been associated with low birth weight and death. Placental abruption (separation of the placenta from the uterus) has also been associated with these substances.

Heroin and other narcotics can cause fetal death, low birth weight, developmental delay and addiction in the baby. This results in the baby going through withdrawal after delivery.  Signs of withdrawal include sleeplessness, crying and difficulty feeding.

LSD, hallucinogens, and inhalants can cause liver, kidney and brain damage.

Medications should be limited in pregnancy. This includes both prescription and over the counter medications. Your health care provider can tell you if a specific medication should be avoided. Among these are Accutane, Tetracycline, Methotrexate, Clonazepam, and Aspirin.


Caffeine in pregnancy should be reduced or stopped. If you are unable to stop it is recommended that coffee be limited to one cup per day. Less than 200 mg is the daily recommended amount in pregnancy. Remember cola, tea and chocolate also contain caffeine.

Teratogens have been discussed here, however it is important to remember that there are many teratogens in the environment that have not been mentioned. If you are unsure about how something can affect your baby, please discuss it with your health care provider. In general, make healthy choices in what you eat and consume. The health of your baby depends on it. If you want to read more on the subject, I encourage you to buy this book Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk




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