SAN DIEGO, Calif. - The California Department of Public Health announced recently it has expanded pertussis (whooping cough) vaccination recommendations to include several vulnerable groups of people, including women of childbearing age. The Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America that aims to prevent birth defects, answers questions from pregnant women concerned the vaccine could impact their pregnancy.
On April 20, 2010 an explosion caused an oil rig to leak large amounts of oil into the Gulf of Mexico. This has raised concerns for pregnant women living near the spill. In general, residents are expected to have only low level exposures and minimal to no symptoms, and therefore should be reassured that their pregnancies are not likely to be at increased risk.
Many of the chemicals in the spill, like fuel and solvent fumes, have a low smell threshold meaning that they can be smelled even at levels not thought to affect health. Therefore, even though you may be able to smell a gas station-like smell, the chemicals can still be at low levels, and unlikely to cause a problem for you or the baby. According to recent updates from the Environmental Protection Agency or EPA (http://www.epa.gov/bpspill/) the air and water quality within the Gulf region are at normal levels.
The level of the chemicals is a key factor because the oil, gas and solvent fumes may pose an increased risk to a pregnancy when they are inhaled in very high amounts (usually for the purpose of intoxication or “to get high”). A syndrome similar to fetal alcohol syndrome (characteristic facial features and brain and growth problems) has been suggested following reports of women purposely inhaling very high doses of gasoline or solvents to get high. These doses are much, much higher than what could be accidentally inhaled by living in the area. Less severe effects on a pregnancy would be more of a concern with indoor exposures without adequate ventilation and symptoms in the mother rather than outdoor air low exposure.
Individuals with respiratory conditions, like asthma, may be more likely to experience breathing problems even with low levels of chemical inhalation. Some people may experience headache or nausea from the smells even with low levels of chemicals.
Since drinking water does not come from the salt water gulf, drinking water should not be affected.
Pregnant and breastfeeding women are advised to follow the recommendations of the EPA and their local health departments in terms of swimming and fish consumption. As always, if there are concerns regarding any particular exposure, women and their health care providers are encourage to call OTIS at 1-866-626-6847 to speak with one of our specialists.
Washington D.C. – The first step to create a public awareness program in an effort to prevent birth defects was introduced to Congress late last week much to the applause of the Organization of Teratology Information Specialists, a non-profit dedicated to providing accurate evidence-based, clinical information to patients and health care professionals about exposures during pregnancy and lactation through its toll-free (866) 626-6847 hotline.
Congresswoman Rosa L. DeLauro (CT-3) and Congressman Michael C. Burgess, M.D. (TX-26) introduced the Birth Defects Prevention, Risk Reduction, and Awareness Act of 2010 which, if passed, would establish a grant program to boost a national network of pregnancy health information services, including OTIS and its affiliates. “The legislation is critical for the U.S. because Teratogen Information Services, which have served women and children in the U.S. for over 20 years have had sporadic and inconsistent sources of local and state funding. Because of this, many services have not been able to continue to function and access to important health information has not been available,” said Dr. Christina Chambers, the program director of the CTIS Pregnancy Health Information Line, the California affiliate of OTIS, and associate professor of Pediatrics at the University of California San Diego. “Enactment of this bill will provide a stream of funding to TIS's across the nation who will be able to continue to provide high quality safety information to pregnant women and their health care providers and thereby improve the health of children in our country,” she explained.
Nearly 100,000 women seek information about birth defect prevention from organizations like OTIS every year. “Every American should support this legislation because birth defects that are caused by risky prenatal exposures can be prevented by avoiding those exposures,” said Dr. Chambers. “Birth defects are the leading cause of infant mortality, and if we can prevent even a small fraction of these, we have improved the health of our children and the nation,” she added.
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For more information or if you would like to schedule an interview, please contact Nicole Chavez at (619) 294-6262. Spanish-speaking interviews are also available.
SAN DIEGO, Calif. - The Organization of Teratology Information Specialists, together with the American Academy of Asthma, Allergy & Immunology (AAAAI) and Slone Epidemiology Center at Boston University (SEC), has launched a nationwide surveillance system to examine the safety of vaccines and medication during pregnancy. The Vaccines and Medications in Pregnancy Surveillance System (VAMPSS) will initially focus on the effects of vaccines such as the H1N1 and seasonal influenza. In addition, VAMPSS will examine influenza anti-viral and asthma medications during pregnancy. To read more about VAMPSS click here. To learn more about OTIS’ role in the project and how you can get involved with VAMPSS click here.
Women who inadvertently become pregnant while being treated with leflunomide (Arava) for rheumatoid arthritis are not at increased risk of causing major defects in their unborn child, according to a recent study published in the online version of the journal Arthritis & Rheumatism.
Women who took Arava had a 5.4 percent rate of major structural defects while a disease-matched comparison group and a healthy comparison group each had rates of 4.2 percent. According to principal investigator Christina D. Chambers, PhD, MPH, of the Department of Pediatrics at the University of California, San Diego School of Medicine, that is not a significant difference from the 3 to 4 percent rate expected in the general population. In addition, there was no specific pattern of minor malformations in the women who used Arava early in pregnancy.
“The recommendation still stands that leflunomide should be avoided in pregnancy and, if a woman becomes pregnant, she should go through the drug washout procedure,” explained Chambers. “And though ours is a small study which cannot definitively rule out increased risks for specific major congenital defects with prenatal leflunomide exposure, the findings can help clinicians to better counsel those patients who have very early pregnancy exposure and have gone through the washout procedure.”
For 10 years, Chambers and colleagues from the Organization of Teratology Information Specialists (OTIS) Collaborative Research Group conducted a pregnancy outcome study of women with first-trimester exposure of any duration to the drug. Participants were recruited from the 70,000 pregnant women who call the OTIS counseling program throughout the U.S. and Canada each year, as well as from contacts with rheumatologists. Sanofi-Aventis, the drug manufacturer, also encouraged referrals.
A total of 250 participants from the U.S. and Canada enrolled in the study – 64 in the leflunomide-exposed group, 108 in the disease-matched comparison group, and 78 in the healthy comparison group. The women in the exposed group had rheumatoid arthritis or juvenile rheumatoid arthritis and had taken at least one dose of the drug after conception.
A unique feature of this study was the specialized physical examination conducted for the majority of live-born infants by one of a team of pediatric dysmorphologists led by co-principal investigator, Kenneth Lyons Jones, MD, chief of the division of dysmorphology and teratology in the UCSD Department of Pediatrics. These blinded physical examinations were conducted in the participant’s location and allowed the investigators to determine that there was no specific pattern of minor anomalies in infants born to mothers exposed to Arava.
This is the first human study on this Category X medication, one of only six medications in the U.S.in this category. A Category X designation indicates that the drug is to be avoided in pregnancy under all circumstances, as it is presumed to cause birth defects, leading to almost universal termination of pregnancy. These study results have already prompted a label change for leflunomide in Europe.
In addition to Chambers and Jones, the research team included Diana L. Johnson, MS; Janina Lopez-Jiminez, MA; Nicole Mirrasoul, BS; Elizabeth Salas, BA; and Yunjun Luo, MS of the Department of Pediatrics, UC San Diego and Rady Children’s Hospital, San Diego; as well as Ronghui Xu, PhD, Department of Family and Preventive Medicine and Department of Mathematics, UC San Diego; Shelia Jin, MD, MPH, Department of Family and Preventive Medicine, UC San Diego; Luther K. Robinson, MD, Department of Pediatrics, University of Buffalo; and Stephen R. Braddock, MD, Department of Pediatrics, University of Virginia.
*Source: *http://www.ucsd.edu/
Upcoming Meetings
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August 4 - August 8, 2010
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