OTIS, a network of health care professionals across the U.S. and Canada, recently launched a new study to help monitor pregnancy outcomes in women who have received the 2009 H1N1 virus vaccines.

The Organization of Teratology Information Specialists (OTIS), a network of health care professionals across the U.S. and Canada, is providing expanded toll-free telephone access to counseling services for pregnant women.

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Stockton Record

Pregnant women are especially vulnerable to complications from the H1N1 virus, also known as swine flu, and are being strongly urged by medical experts to get immunized as soon as the H1N1 vaccine becomes available.

It's a message that can't be stressed enough this year, those experts say, since only about 20 percent of pregnant women typically get the seasonal flu vaccine each year. With the H1N1 virus sweeping the nation, no one has immunity except some people older than 60.

"Long before this pandemic, pregnant women were told to get the seasonal flu vaccine since it's been known for some time they are more likely to have complications such as respiratory failure and pneumonia and so on," said Dr. Christina Chambers, program director of the California Teratogen Information Service Pregnancy Risk Line and associate professor of pediatrics at the University of California, San Diego School of Medicine.

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(SAN DIEGO) October 15 2009 -The California Teratogen Information Service (CTIS)– a non-profit housed at the University of California, San Diego School of Medicine and serving the entire state of California – urges women who are pregnant or may become pregnant to receive the H1N1 2009 monovalent vaccine as soon as it becomes available in October. 

Since the advent of the H1N1 virus pandemic, research from the U.S. Centers for Disease Control (CDC) strongly suggests that pregnant women are at an increased risk for complications resulting from infection with the H1N1 virus just as they are from seasonal influenza.

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ABC News Antidepressants in Pregnancy up Heart Defect Risk

NEW YORK (Reuters Health) - If you take antidepressants such as fluoxetine (marketed as Prozac) early in your pregnancy, you may be doubling the risk that your newborn will be born with a heart defect, according to a new study.

However, the vast majority of children born to women who take such antidepressants - known as selective serotonin reuptake inhibitors (SSRIs) - do not have such defects, the researchers are quick to note.

Still, in an accompanying editorial, Dr. Christina Chambers, from the University of California, San Diego, comments that doctors and patients "need to balance the small risks associated with SSRIs against those associated with undertreatment or no treatment."

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CTIS Newsletter vol 1.3

During pregnancy, a woman’s estrogen level increases. High levels of estrogen have been suspected as one cause of nausea and vomiting during pregnancy (NVP). It has been estimated that as many as 80% of pregnant women develop NVP. Since Bendectin was removed from the market in the U.S. many years ago, clinicians have had to find alternative strategies to treat NVP. Metoclopramide enhances GI motility and is an effective antinauseant. Although, it is not FDA-approved for NVP, it was originally developed to treat nausea during pregnancy. At least six countries in Europe and Israel use metoclopramide as an antiemetic treatment for NVP. To date, available data on metoclopramide use in pregnancy, based on small-scale studies, is not suggestive of an increased risk for major birth defects.

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by Gerald G. Briggs, BPharm, FCCP

Diabetes mellitus can be classified into three types:

type 1: autoimmune disease that results in β-cell destruction, usually leading to absolute insulin deficiency; ketoacidosis prone; may have a late onset and slow progression of disease; pregestational diabetes

type 2: non-autoimmune disease that results in progressive insulin secretory defect on the background of insulin resistance; ketoacidosis resistant; pregestational diabetes

type 3: diabetes diagnosed during pregnancy, called gestational diabetes.

Diabetes mellitus is the most common medical complication of pregnancy, occurring in 2%-3% of all pregnancies. Approximately 90% of these represent gestational diabetes mellitus (GDM; type 3) where the onset or recognition of glucose intolerance occurs during pregnancy. Most of these cases represent true GDM in which glucose intolerance disappears after delivery, but a significant number are newly diagnosed type 2 diabetics. The distinction is important because poorly controlled pregestational diabetes can cause all aspects of developmental toxicity (growth alteration, structural anomalies, functional/neurobehavioral defects, and death), whereas true GDM does not cause structural anomalies because its onset is after organogenesis. Suboptimal treatment of this disease, indicated by a hemoglobulin A1c (HbA1c) above (>6%) the normal, is associated with significant maternal, embryo, fetal, neonatal, childhood and adolescent morbidity and mortality. Thus, tight control of the blood glucose level in pregnant diabetic patients is a primary therapeutic goal.

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CTIS ACKNOWLEDGES TENTH ANNIVERSARY OF FETAL ALCOHOL SPECTRUM DISORDER AWARENESS DAY

(San Diego) Sept.  2009– The San Diego-based, non-profit California Teratogen Information Service (CTIS) requests recognition of the 10th anniversary of Fetal Alcohol Spectrum Awareness Day on Sept. 9,  a day dedicated to increasing awareness about fetal alcohol syndrome (FAS), the nation's leading cause of preventable mental retardation.

“If women of childbearing age are made aware of the dangers of drinking during pregnancy early on, we will have more success in getting women to abstain from drinking during their pregnancies,” said Dr. Christina Chambers, the program director of the CTIS Pregnancy Risk Line and associate professor of Pediatrics at the University of California San Diego. “FASD Awareness Day plays an important role to provide support and information to expectant mothers of the irreversible condition of fetal alcohol syndrome.”

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by Philip O. Anderson, Pharm.D., FASHP, FCSHP

Breastfeeding is acknowledged as the standard against which other methods of infant feeding are judged. No artificial feeding method comes close to providing the benefits of breastfeeding in terms of infant and maternal health. All major national and international healthcare organizations with policy statements on breastfeeding recommend exclusive breastfeeding for 6 months with continued breastfeeding thereafter.

Sometimes nursing mothers need a medication. Almost any medication will reach the breastmilk in some quantity. However, the amount that appears in milk is usually not great enough to harm a nursing infant.

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Thu Aug 13, 2009 5:56pm EDT

SAN DIEGO, CA, Aug 13 (MARKET WIRE) --
The California Teratogen Information Service (CTIS) -- a non-profit housed at the University of California, San Diego School of Medicine and serving the entire state of California -- has joined with San Diego State University's Women, Infants and Children (WIC) program in a project aimed to prevent alcohol consumption during pregnancy.

Funded by a grant from the Agency for Healthcare Research and Quality, CTIS will evaluate the effectiveness of an adapted web-based alcohol program that aims to measure and reduce current alcohol consumption among low-income non-pregnant women participating in WIC's Special Supplemental Nutritional Program.

"Our mission is to educate women on risks and to promote a healthy pregnancy outcome," said Dr. Christina Chambers, the program director of the CTIS Pregnancy Risk Line and associate professor of Pediatrics at the University of California, San Diego. "Heavy prenatal alcohol use is a common known cause of adverse effects in a developing baby and is completely preventable. This program has great potential to address this critical issue using 21st century technology."

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CTIS Newsletter 1.2

CTIS Newsletter 1.1

By THE ASSOCIATED PRESS
Published: June 22, 2009

WASHINGTON (AP) -- Drinking during pregnancy can seriously harm a baby's brain, yet thousands of mothers-to-be still do. Now scientists have begun testing whether a prenatal nutrient might offer those babies a little protection, part of a growing quest for ways to reverse the damage.

The only help today: intense behavioral or educational therapies once children with fetal alcohol-caused disabilities reach preschool or school age, says new research by the Centers for Disease Control and Prevention. The agency is spending $1.5 million this year to start spreading those programs so more youngsters can find care.

Better would be discovering a way to short-circuit what scientists now know is a complex chain reaction of toxicity that even moderate drinking during pregnancy -- and especially a binge -- can trigger in a baby's developing brain.

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First developed in the 1930s, antihistamines are currently the most commonly used drugs for seasonal allergies. They have been used clinically in the general population and are available over-the counter or through prescription. In pregnancy, antihistamines are also sometimes used to treat nausea and vomiting of pregnancy. The prevalence of antihistamine use, anytime during pregnancy, ranges from 8 – 15%. First-generation antihistamines include clemastine fumarate, dimenhydrinate, diphenhydramine, doxylamine, hydroxyzine, meclizine, pheniramine, promethazine, and triprolidine. Whereas, second-generation anithistamines include cetirizine, fexofenadine, and loratadine. When used as suggested or prescribed, these medications can minimize symptoms of allergy by blocking the histamine reaction to allergens, thereby preventing other potential complications from untreated allergies. But how safe are antihistamines during pregnancy?

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Management of Asthma During Pregnancy Can Optimize Health of Mother and Baby, According to Recommendations

Kaiser Permanente lead author recommends comprehensive approach to management and treatment of asthma

SAN DIEGO, Calif. — Pregnant women with asthma, the most common condition affecting the lungs during pregnancy, should actively manage their asthma in order to optimize the health of mother and the baby, according to new management recommendations published in the current issue of the New England Journal of Medicine.

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CONTACT:    Audrey Doherty/Jordan Cole
        (619) 236-8397

CTIS ISSUES SPRING ASTHMA AND ALLERGY SEASON ALERT FOR
PREGNANT WOMEN AND BREASTFEEDING MOMS

Experts Announce that Management of Asthma and Allergies Can Benefit Mom and Baby

(SAN DIEGO) May 1, 2009 – Expectant moms are urged to seek treatment for asthma and allergies according to the medical staff and advisory board of the San Diego-based California Teratogen Information Service (CTIS). CTIS is a non-profit founded and directed by faculty and staff from the University of California, San Diego School of Medicine and serving the entire state of California.

Released in conjunction with Asthma and Allergy Awareness Month, the alert is targeted to women who are pregnant, breastfeeding or considering becoming pregnant and who suffer from asthma or allergies. This important information can promote a safe pregnancy and delivery, and a healthy baby.

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Doctors answer readers' questions about neurofibromatosis

Los Angeles Times

April 13, 2009

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Information for those Considering Adoption

By Michelle Dern, MD FAAP

The decision to adopt a child, whether foreign or domestic, is one that requires careful consideration. The prenatal environment may have a profound influence on the life of the child. Unfortunately, in many cases the details of this critical time are unknown. Prospective parents in the process of adoption should learn as much as possible about the health and habits of the birth mother.

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CTIS NAMES SCIENTIFIC ADVISORY BOARD

Leading medical authorities join effort to prevent exposures that cause birth defects

SAN DIEGO, Calif. (April 15, 2009) –Seventeen leading medical authorities from prominent universities and health care organizations throughout the state have been named to the scientific advisory board of the California Teratogen Information Service (CTIS), a nonprofit group that provides research and education that helps prevent prenatal exposures to drugs, alcohol, medications and other toxins that can cause birth defects.

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NEW ONLINE SERVICE HELPS EXPECTANT MOMS
Web site provides information about potential risk from exposure to medications, chemicals and other agents

(SAN DIEGO) March 5, 2009 – Moms-to-be concerned about potential risks of taking cold medication or using certain cleaning products can now find helpful information online and over the phone.

A new Web site (www.ctispregnancy.org) offering expectant moms a one-stop source for finding the latest information about the potential risks of exposure to drugs, chemicals and other harmful agents has been launched by the California Teratogen Information Service (CTIS).

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By David Schatz, MD

Treatment of medical illness during pregnancy is often complicated. Though the common medications used to treat illness can do wonderful things, a certain number can have negative effects on the unborn child. Thus, a mother and her doctor are left with the difficult decision of deciding if a treatment during pregnancy is worth the possible risk to the baby. Nowhere are these facts truer than in the treatment of Major Depressive Disorder (MDD) during pregnancy.

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Numerous studies over two decades have associated use of sodium valproate or valproic acid (VPA) during pregnancy with a characteristic pattern of major and minor malformations...

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At first, the world celebrated Nadya Suleman's octuplets as a medical miracle. But reaction to the Jan. 26 births quickly devolved from ballyhoo to backlash after the public learned that she had six other children through in vitro fertilization and was living on welfare.

Ethicists, medical providers and average citizens are asking why any physician would help Suleman, a single mother in Whittier, have that many children. Some said the case is evidence that the nation's $3 billion, self-regulated fertility industry needs government oversight.   Read More
 

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