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The Questions of Developmental Biology

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Table 21.2. Some agents thought to cause disruptions in human fetal development a<br />

DRUGS AND CHEMICALS IONIZING RADIATION (X-RAYS)<br />

Alcohol<br />

HYPERTHERMIA<br />

Aminoglycosides (Gentamycin) INFECTION MICROORGANISMS<br />

Aminopterin<br />

Coxsackie virus<br />

Antithyroid agents (PTU)<br />

Cytomegalovirus<br />

Bromine<br />

Herps simplex<br />

Cigarette smoke<br />

Parvovirus<br />

Cocaine<br />

Rubella (German measles)<br />

Cortisone<br />

Toxoplasma gondii (toxoplasmosis)<br />

Diethylstilbesterol (DES)<br />

Treponema Pallidum (syphilis)<br />

Diphenylhydantoin<br />

METABOLIC CONDITIONS IN THE MOTHER<br />

Heroin<br />

Autoimmune disease (including Rh incompatibility)<br />

Lead<br />

Diabetes<br />

Methylmercury<br />

Dietary deficiencies, malnutrition<br />

Penicillamine<br />

Phenylketonuria<br />

Retinoic acid (Isotretinoin, Accutane)<br />

Streptomycin<br />

Tetracycline<br />

Thalidomide<br />

Trimethadione<br />

Valproic acid<br />

Warfarin<br />

Source: Adapted from Opitz 1991.<br />

a This list includes known and possible teratogenic agents and is not exhaustive.<br />

Quinine and alcohol, two substances derived from plants, can also cause congenital<br />

malformations. Quinine can cause deafness, and alcohol (when more than 2 3 ounces per day are<br />

imbibed by the mother) can cause physical and mental retardation in the infant. Nicotine and<br />

caffeine have not been proved to cause congenital anomalies, but women who are heavy smokers<br />

(20 cigarettes a day or more) are likely to have infants that are smaller than those born to women<br />

who do not smoke. <strong>The</strong>re is controvery over whether cigarette smoking enhances the risk <strong>of</strong> facial<br />

anomalies. Smoking also significantly lowers the number and motility <strong>of</strong> sperm in the semen <strong>of</strong><br />

males who smoke at least four cigarettes a day (Kulikauskas et al. 1985).<br />

In addition, our industrial society produces hundreds <strong>of</strong> new artificial compounds that<br />

come into general use each year. Pesticides and organic mercury compounds have caused<br />

neurological and behavioral abnormalities in infants whose mothers have ingested them during<br />

pregnancy. Moreover, drugs that are used to control diseases in adults may have deleterious<br />

effects on fetuses. For example, valproic acid is an anticonvusant drug used to control epilepsy.<br />

It is known to be teratogenic in humans as it can cause major and minor bone defects. Barnes and<br />

colleagues (1996) have shown that valproic acid decreases the level <strong>of</strong> Pax1 transcription in chick<br />

somites. This causes the malformation <strong>of</strong> the somite and the corresponding malformations <strong>of</strong><br />

vertebrae and ribs.

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