Taking drugs and exposure to radiation for preconception health

In 1988, the Agostino Gemelli University Hospital Foundation activated 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 drugs or exposure to radiation during diagnostic tests that have perhaps been carried out before discovering that they are pregnant. These worries can lead to fearful behaviors, such as deciding to terminate the pregnancy, although the real 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 "teratogenic" 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 anomalies 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. It is important to underline that only 14% of the cases examined by the service highlighted a real risk to the health of the fetus: 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-conceptional periods. As far as diagnostic radiation is concerned, it is always administered at such low dosages that they never reach 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, equal to 95% of total consultations, it is possible to reassure these women, as the risks they run after such events can be well identified and quantified.
There are, however, some teratogenic drugs (24% of total drugs) for which 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), a waiting period must be respected before conception. In the case of isotretinoin, for example, it is advisable to wait at least a month before trying to get pregnant to avoid the risk of malformations in the central nervous system, heart or ear of the baby.

Every year, "Il Telefono Rosso" receives about two thousand calls, demonstrating how fundamental 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 live their pregnancy with more serenity and awareness.