Australian Birth Defects Society

A Society devoted to the study of birth defects

Quick round-up of interesting articles that have passed my desk this month.

Journal Club

February 2017

Prenatal cannabis exposure - The “first hit” to the endocannabinoid system Neurotoxicology and Teratology xxx (2016) xxxxxx

An interesting review of cannabis exposure during pregnancy. The authors concede that is no evidence of structural, cognitive, behavioural or functional abnormalities due to exposure during pregnancy. However marijuana use during pregnancy is hypothesised to perturb the fetal endogenous cannabinoid signalling system which is important in regulating cardiovascular processes. Thus they propose a two-hit hypothesis with prenatal exposure predisposes exposed offspring to abnormalities in cognition and altered emotionality.


Pregnancy outcomes after maternal varenicline use; analysis of surveillance data collected by the European Network of Teratology Information Services. Reproductive Toxicology 67 (2017) 26–34.

 Varenicline (Champix) is a smoking cessation aid. This ENTIS study compared 89  Varenicline first-trimester-exposed pregnancies with 267 control and 78 nicotine-replacement or bupropion replacement pregnancies. There was no increase in major malformation rate.

Assessment of YouTube videos as a source of information on medication use in pregnancy. Pharmacoepidemiology and drug safety 2016; 25: 3544

The internet is already a large source of information for mothers but YouTube also videos also discuss drug use in pregnancy. This study viewed 314 videos finding the majority were from law firms (67%). The most common class of drug was SSRIs (72%) with 88% of these claiming SSRIs were unsafe for use on pregnancy in contrast to TERIS which rates this drug class as a “minimal” or “unlikely” risk. 

December 2016

Page updated 6 February 2017

Gestational nanomaterial exposures: microvascular implications during pregnancy, fetal development and adulthood. J Physiol (2016) 594:2161-73

A systematic review of literature encompassing nanoparticle exposure before, and during pregnancy as well as possible effects in adults. Possible mechanisms of action are described.


Maternal nutritional status as a contributing factor for the risk of fetal alcohol spectrum disorders. Repro Toxicol (2016) 59:101-8.

This South African study compared  the nutritional status of mothers of children with FAS. They found that most mothers were deficient in most micronutrients. Although control mothers had a higher BMI than FAS mothers. Maternal BMI is more significant for positive, food intake was similar. The authors conclude that any minor advantages in nutrient intake were overpowered by teratogenic effects of alcohol.


Serotonin and poor neonatal adaptation after antidepressant exposure in utero. Acta Neuropsych (2017) 29:43-53.

Poor neonatal adaptation, such as restlessness, tremors or sleeping difficulties are observed in babies exposed to psychotropic medications in late gestation. This study included 63 infants exposed to selective antidepressants (SAD) in the last 2 weeks of pregnancy. The neonatal 5-hydroxyindoleacetid acid (5-HIAA) levels were followed for the first 3 days postpartum. 5-HIAA levels were higher in babies with poor neonatal adaptation on Day 1 compared to SAD-exposed infants who did not develop adaptation problems.