Pregnancy Riskline Provides Counseling About Potentially Dangerous Exposures

FARMINGTON –– Most people know by now that pregnant women should not smoke cigarettes or drink alcohol. It is not good for their unborn babies, and the danger is clearly stated in the warning labels carried on packages of cigarettes and bottles of beer and wine.

But there are thousands of unlabeled potential threats to the unborn, and questions about them can be directed to the Pregnancy Exposure Information Service at UConn Health Center. The service, which is part of the Division of Human Genetics in the Department of Pediatrics, operates a statewide telephone Riskline that gets more than 1,700 calls every year from women or their doctors seeking information about the effects of a prenatal exposure on a baby.

"There's no master list of safe substances," said Sharon Voyer Lavigne, genetic counselor and coordinator of the service. "But we can assess the exposure and help the woman or her doctor understand the risk, based on the latest available information," she said. "Most substances taken by an expectant mother will not harm the unborn baby," she said.

There are 30 Pregnancy Risklines around the country that provide up-to-date information on all types of exposures during pregnancy, and they are members of a national network of risklines known as the Organization of Teratology Information Services, OTIS. (Teratology is the study of the effects that drugs, medications, chemicals, and other exposures may have on a fetus.)

"Our collaboration with the other services around the country and the world enables us to gain more information and more knowledge about the effects of prenatal exposures," said Sally Shulman Rosengren, MD, medical director for the Connecticut service. "In fact, OTIS just completed a multiyear study on the effects of various asthma medications on pregnancy. Once the data is thoroughly analyzed, it will help us better evaluate whether these medications pose a risk to pregnant women and their babies," said Dr Rosengren.

Most of the calls to the Riskline come from women who are pregnant or planning to become pregnant. They want to know about the potential risks to a baby from medications or infectious diseases, the use of drugs or alcohol or from occupational and environmental exposures. "For example, a woman will call and say she wants to get pregnant but her husband takes medication. She wonders if that would affect the baby," said Ms Lavigne. "Or the woman might be taking medication for depression or bipolar disorder and she wonders how those drugs might affect the baby," she said.

The Riskline also gets calls from women wondering about hazardous exposures because of their jobs or their partner's jobs. Workplace exposures include chemicals, ionizing radiation, or physical agents like vibration, shift rotation, or loud noise. "In these cases, we usually coordinate patient care with the Health Center's Division of Occupational and Environmental Medicine," said Ms Lavigne.

Riskline callers are asked about their exposures to medications, chemicals, and illnesses and they are assigned to a genetic counselor or a teratogen information specialist. The counselor will call them back with information about the exposure, usually in one to three days. In some complex cases, the callers may need to wait several days while information is collected and reviewed, or they may be asked to come in for a detailed discussion about their exposure. Most callers receive a follow-up letter in the mail that summarizes the information they were given. In some cases, they may be contacted later about the outcome of the pregnancy for research purposes.

The Pregnancy Exposure Information Service is supported by a grant from the state Department of Public Health. Hours of operation are Monday to Thursday, 8 am to 4 pm, and on Friday from 8 am to noon. When the office is not in operation, callers get a recording so they can leave their name and telephone number and get a call back. The telephone number is 800-325-5391.