Maternal Use of Cytostatic/Cytotoxic Drugs or Endocrine Drugs for Malignancy and Infant Congenital Malformations

  • Bengt Källén


For most cytotoxic drugs, when used during the first trimester for maternal malignancy, a substantial risk for teratogenesis may exist and such use should be avoided. If inadvertent exposure occurs, one has to calculate with a fetal risk and the possibility of induced abortion (when available) should be discussed. When used as immune suppressants at other diseases (e.g., rheumatoid arthritis or immunological bowel disease), lower doses are usually used and the risk for teratogenesis seems reduced even for a known teratogen like methotrexate. Exposures for these drugs are relatively rare but in the individual case a careful consideration of the risk is needed. Unfortunately information for individual drugs or combinations of drugs is often incomplete.


  1. Artlich A, Möller J, Tschakaloff A, Schwinger E, KruseK GL. Teratogenic effects in a case of maternal treatment for acute myelocytic leukaemia—neonatal and infantile course. Eur J Pediatr. 1994;153:488–91.PubMedGoogle Scholar
  2. Avilés A, Neri N, Nambo M-J. Hematological malignancies and pregnancy: treat or no treat during first trimester. Int J Cancer. 2012;131:2678–83.CrossRefGoogle Scholar
  3. Ben-Chetrit E, Ben-Chetrit A, Berkun T, Ben-Chetrit E. Pregnancy outcomes in women with familial Mediterranean fever receiving colchicine: is amniocentesis justified? Arthritis Care Res. 2010;62:143–8.CrossRefGoogle Scholar
  4. Berkenstadt M, Weisz B, Cuckle H, Di-Castro M, Guella E, Barkai G. Chromosomal abnormalities and birth defects among couples with colchicine-treated familial Mediterranean fever. Am J Obstet Gynecol. 2005;193:1513–6.CrossRefGoogle Scholar
  5. Braems G, Denys H, De Wever O, Cocquyt V, Van den Broecke R. Use of tamoxifen before and during pregnancy. Oncologist. 2011;16:1547–51.CrossRefGoogle Scholar
  6. Diav-Citrin O, Shechtman S, Schwartz V, Avgil-Tsadok M, Finkel-Pekarsky V, Wainberg R, Amon J, Berkowitch M, Ornoy A. Pregnancy outcome after in utero exposure to colchicine. Am J Obstet Gynecol. 2010;144:e1–6. Scholar
  7. Rabinovitch O, Zerner D, Kukia E, Sohar E, Mashiach S. Colchicine treatment in conception and pregnancy: two hundred thirty-one pregnancies in patients with familial Mediterranean fever. Am J Reprod Immunol. 1992;28:245–6.CrossRefGoogle Scholar
  8. Schardein JL. Cemically induced birth defects. New York: Marcel Dekker; 1985.Google Scholar
  9. Selig BP, Furr JR, Huey RVV, Moran C, Medders GR, Mumm CD, Hallford HG, Mulvihill JJ. Cancer chemotherapeutic agents as human teratogens. Birth Defects Res A Clin Mol Teratol. 2011;94:626–50.CrossRefGoogle Scholar
  10. Thiersch JB. Therapeutic abortions with a folic acid antagonist 4-amino-pteroyglutamic acid administered by the oral route. Am J Obstet Gynecol. 1952;63:1298–304.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bengt Källén
    • 1
  1. 1.Tornblad Institute for Comparative EmbryologyLund UniversityLundSweden

Personalised recommendations