Medication Intake and Radiation Exposure for Preconception Health

In 1988, the Agostino Gemelli University Hospital Foundation launched the free medical service "Il Telefono Rosso", designed to support pregnant women and new mothers. Created in collaboration with Università Cattolica del Sacro Cuore and the Lazio Region, this service aims to offer advice to expectant mothers who, especially in the early stages of pregnancy, are concerned about any harmful effects caused by taking medication or exposure to radiation during diagnostic tests that have, perhaps, been carried out before discovering they are pregnant. These worries can lead to fear-driven behaviors, such as deciding to terminate the pregnancy, although the actual risks are usually very limited.

Unfortunately, all pregnancies have a natural risk of birth defects, which can be diagnosed at birth or in the first year of life, of 5%. This risk can be increased by physical (radiation), chemical (drugs), biological (virus) teratogenic agents. According to the National Institute of Health, a "teratogen" is defined as a compound, substance or condition capable of inducing alterations in the normal development of the fetus during pregnancy and causing miscarriage or congenital malformations, or after birth, which cause permanent damage to health. The science that studies birth defects and the environmental contribution to abnormalities is teratology. The effects of a teratogen can include miscarriages, morphological abnormalities, and organ dysfunction. To identify the risk associated with a given exposure, the Operators of the "Il Telefono Rosso" service consult international databases and other up-to-date sources. Importantly, only 14% of the cases examined by the service revealed a real risk to the health of the foetus: fortunately, most of the drugs and radiation to which one is exposed do not pose a significant danger. It must be considered that dangerous drugs for pregnancy are few and well identified and some of these can also be used in peri-conception periods. As far as diagnostic radiation is concerned, it is always administered at such low dosages that it never reaches known alarm levels. In fact, the threshold dose suspected to produce birth defects is higher than the doses used in diagnostic tests.

In most cases, i.e. 95% of total consultations, it is possible to reassure these women, as the risks incurred after such events can be well identified and quantified.
On the other hand, there are some teratogenic drugs (24% of total drugs) for which a controlled administration is necessary, especially for those taken by women for chronic diseases (for example, epilepsy or autoimmune diseases); For some medications, such as retinoids (used to treat cystic acne), there is a waiting period before conception. In the case of isotretinoin, for example, it is recommended to wait at least a month before trying to become pregnant to avoid the risk of malformations of the baby's central nervous system, heart or ear.

Every year, "Il Telefono Rosso" receives about two thousand calls, demonstrating how essential the service is for pregnant women and new mothers. Thanks to its network of experts and the continuous availability of scientific data, the service plays a crucial role in reassuring women about their concerns and ensuring that they can experience pregnancy with more serenity and awareness.