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A report first published last October by the U.S. National Library of Medicine and the National Institute of Health found that medication taken to treat hyperthyroidism in pregnant women led to birth defects. The report was based on a study which examined more than 815,000 children born between 1996 and 2008. Those who were exposed to hyperthyroid medication early in the pregnancy were more likely to experience birth defects. However, the spectrum of malformations varied considerably.

Drugs used to treat hyperthyroidism are shorthanded as ATDs. According to UpToDate.com, most antithyroid drugs (ATDs) have few risks and side effects. Patients who have an overactive thyroid can have the condition permanently or temporarily. An example of permanent hyperthyroidism would be that brought on by Grave's disease. On the other hand, pregnant women can experience hyperthyroidism. In these cases, ADTs are given to the women temporarily. The 2013 report suggests that new ADTs should be found for use with pregnant women.

There are two main types of ADTs available in the U.S. as of right now. These are Methimazole (MMI) and Propylthiouracil (PTU). MMI, according to UpToDate.com, has a faster onset time and fewer side effects. PTU takes more time to enter the blood stream. However, recent research has found that PTU has a lower risk for pregnant women. Experts now say even PTU should only be given to pregnant women in the first trimester.

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Around the world, selective serotonin reuptake inhibitors (often called SSRIs) are some of the most commonly prescribed depression medications. In the United States, one of the most popular SSRIs given to patients with depression is Zoloft, which has been linked to dangerous birth defects when taken by pregnant mothers. A new study from the British Medical Journal is the latest authority to lend credence to the risks posed by antidepressants.

The researchers, who reviewed a series of seven studies, found that the risk of persistent pulmonary hypertension of the newborn was different based on the period of the pregnancy in which the mother took the medication. When SSRIs like Zoloft were taken in the later stages of a pregnancy, mothers faced an increased risk that their children would be affected by PPHN.

Although researchers noted that the risk was comparatively low, PPHN is a serious condition that no parent wants to face. In this condition, the baby's lungs are unable to properly exchange oxygen and carbon dioxide. As a result, a newborn could have very low blood oxygen levels, possibly causing damage to organs.

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Isotretinoin, also known as Accutane and one of the most effective medications for acne, is reported to cause severe birth defects to an exposed fetus. Because of this, the U.S. Food and Drug Administration created the computer-based risk management program iPledge, requiring women to review educational materials, complete tests and pledge to use two forms of birth control prior to using the drug.

However, a recent report indicates that the iPledge program been less than successful, and a small study suggests the focus be placed on more highly effective birth control methods. Dr. Eleanor Bimla Schwarz, director of the Women's Health Services Research Unit of the Center for Research on Health Care at the University of Pittsburgh and the senior author of the study, stated, “What we found is that people need a clear message about what birth control would be most effective, and currently the iPledge materials don't make it clear to most women who enroll in the program.” Schwarz also told Reuters Health that women who take isotretinoin need more information on IUDs and implants to better protect themselves from pregnancy.

While the iPledge website clearly states the high risk of severe birth defects that isotretinoin can have on an exposed fetus, earlier studies also indicate that the program and previous initiatives have had “limited or no success to prevent pregnancies among women taking the drug.” And according to the American College of Obstetricians and Gynecologists, IUDs and contraceptive implants are the most effective reversible contraceptive, and “do not require ongoing effort on the part of the user for long-term and effective use.” In an email to Reuters Health, a spokesperson for the FDA stated that the agency cannot comment on this specific study or the validity of the statements.

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Posted on in Birth Defects

Recently, the FDA has approved the return of a prescription medicine used to treat morning sickness during pregnancy that was taken off the market about 30 years ago after leading to hundreds of lawsuits that claimed it led to birth defects.

The pill that has been brought back from the dead was called Bendectin in the past, but will now be sold as Diclegis. The FDA never actually stated that the pill was unsafe, but the pharmaceutical company who distributed the pill decided to pull it once the litigation costs outweighed profit.

During the time Bendectin was on the market, over 300 lawsuits were filed against Merrell Dow, the company behind it. These various lawsuits claimed that the drug led to babies being born with deformities. However, no direct link was made between Bendectin and the birth defects it supposedly caused. There was no scientific evidence.

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