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The present study was designed to investigate if exposure to dried ginger during pregnancy would increase the risk of adverse fetal and neonatal outcomes. Participants consisted of 159 singleton pregnant women who received dried ginger as a herbal medication. We also included a control group of 306 pregnant women who had not been exposed to any herbal medication or any known teratogen. No increased risk of major malformations was detected in exposed women (OR = 4.9; 95% CI 0.9-25.5; p = 0.051). The incidence of stillbirths in the exposed group was marginally higher than in the controls (OR = 7.8; 95% CI 0.9-70.3; p = 0.05). The risk was more evident when the exposed group was compared with the general population in the Republic of Korea (OR = 7.9; 95% CI 2.9-21.4; p < 0.0001). Other fetal and neonatal study outcomes investigated in the exposed group were similar (p > 0.05) to the controls. In conclusion, dried ginger does not appear to be a major teratogen. However, due to the limitations of the study, e.g. the large variability in the dose of dried ginger in the exposed group, as well as the concomitant exposure to other herbal medications, the increased incidence of stillbirths requires confirmation in larger cohort studies. [ABSTRACT FROM AUTHOR]

X-ray exposure, especially if directed to the abdominal region, is of major concern for pregnant women and their physicians. In this study, favourable long-term outcomes are reported in a series of babies born to women inadvertently exposed to barium enema, and associated ionising radiation, early in pregnancy. Six singleton babies were vaginally delivered without any evidence of gross malformations. There was one voluntary abortion. Follow-up on five of the babies was performed over the course of at least 4 years. All the children were deemed healthy and had developed milestones according to their age. Our findings support larger studies suggesting barium enema is not a teratogenic agent. Collectively, this research can be used to counsel women undergoing radiological procedures early in pregnancy. [ABSTRACT FROM AUTHOR]

No information is currently available on the safety of methylephedrine, a component of various cold medications available in South Korea. With previous approval by an Institutional Review Board, 349 women inadvertently exposed to methylephedrine during the 1st trimester of pregnancy and an age- and gravidity-matched control group, were enrolled in a prospective cohort study. Study outcomes, for example gestational age at birth, birth weight and major and minor malformations were evaluated in 282 cases and 280 controls. Exposure to methylephedrine was at a gestational age of 4.0 weeks (median), at doses ranging from 52.5 to 1,575 mg/day, for a median duration of 3 (range: 1–30) days. No differences were observed between cases and controls in any of the pregnancy outcomes studied. There were 4/265 (1.5%) babies born with major malformations in the case group and 4/260 (1.5%) in the control group. In conclusion, inadvertent exposure to methylephedrine as a component of over-the counter oral cold remedies in early pregnancy was not associated with an increased rate of adverse pregnancy outcomes. Co-exposure with acetaminophen, cigarette smoking or alcohol did not appear to modify the outcomes. [ABSTRACT FROM AUTHOR]

We assessed the pregnancy outcome of nine women inadvertently transfused with acitretin-contaminated blood products in South Korea. A total of 18 women matched to cases by age, gravidity, and singleton- or twin-pregnancy, and who were transfused with blood products not contaminated with acitretin, was also recruited. There were nine babies born in the case group. No differences (p > 0.05) were observed between cases and controls in the gestational age at delivery (38.3 ± 1.6 weeks vs 37.8 ± 2.2 weeks), birth weight (3,146 ± 874 g vs 3,106 ± 568 g), rate of pre-term deliveries (22.2% vs 11.1%) and rate of low birth weight (<2,500 g) (33.3% vs 16.7%). There was no case of malformation or neurological abnormalities born in either group. In conclusion, inadvertent exposure to acitretin-contaminated blood products was not associated with adverse pregnancy outcomes, probably because of the removal of acitretin and etretinate during the manufacturing process of blood products. [ABSTRACT FROM AUTHOR]

Summary Although the internet may play a role in providing proper teratogen-risk counselling for pregnant women, the experience with this type of service has not been reported. We aimed to compare the pregnancy outcome of women counselled by the internet to women that received typically in-clinic teratogen risk counselling in the clinic. In a prospective cohort design, 1,011 patients were counselled in the clinic and 235 patients were counselled via the internet. Teratogen risk counselling was provided according with the information obtained from medical literature and specialised software. Information about pregnancy outcome (delivery, spontaneous abortion, or termination of pregnancy and major malformations) was obtained from 903 (89.3%) patients from the clinic group and 141 (60%) from the internet group. The amount of alcohol, cigarettes smoked, and millirads of X-ray were greater (&ThickSpace; p &ThickSpace;<&ThickSpace;0.05) in patients counselled by internet than in clinic. The rate of deliveries, ongoing pregnancies, pregnancy terminations, and spontaneous abortions were similar between clinic and internet (χ 2 &ThickSpace;=&ThickSpace;1.32; p &ThickSpace;=&ThickSpace;0.7). Of 498 babies born to mothers counselled in the clinic, major malformations were identified in 3.6%. Of 67 babies born to mothers counselled by internet, major malformations were present in 1.5% (&ThickSpace; p &ThickSpace;=&ThickSpace;0.6). Teratogen-risk counselling by internet and clinic seems to have a similar efficacy in pregnancy outcome. [ABSTRACT FROM AUTHOR]

Despite barium being used as a contrast media for decades, the specific assessment of its safety in pregnant women is scarce. We are reporting the favourable pregnancy outcome in women who were inadvertently exposed to barium swallow and associated ionising radiation, early in pregnancy. A control group of age- and gravidity-matched unexposed pregnant women was also included. There were 32 live-born babies in the exposed group and 94 in the control group. Women had undergone diagnostic upper gastrointestinal tract (UGT) fluoroscopic examination at 3.3 ± 1.5 weeks' gestation. Estimated maternal radiation dose secondary to barium swallow varied widely, the maximum dose was estimated to be 2.45 mSv. Similar pregnancy outcomes were observed between the groups. The number of babies born with major malformations was not significantly different (p = 1.0) between cases and controls: one (3.1%) vs three (3.2%), respectively. In conclusion, our small prospective cohort study of women suggests no association between inadvertent exposure to ionising radiation and barium sulphate during fluoroscopic barium swallow and adverse fetal outcomes. [ABSTRACT FROM AUTHOR]

Several studies have reported an association between depression and folic acid deficiency. We investigated whether intake of prenatal multivitamins containing folic acid (MVandFA) was associated with decreased rates of depression among pregnant women. A questionnaire was given to 1,314 low-risk pregnant women. Of them, 1,277 (97.2%) women completed the questionnaire. The overall prevalence of depression was 8.1%. Of 652 participants who did not take MVandFA, 9.4% had depression, whereas 6.9% of 624 women who had MVandFA had depression (p = 0.11). In a multivariate logistic regression analysis, family history of depression (adjusted OR 3.7; 95% CI 1.9-7.3) and premenstrual syndrome (adjusted OR 3.0, 95% CI 1.8-4.8) were identified as risk factors for depression during pregnancy. In conclusion, intake of MVandFA was not associated with lower rates of depression during pregnancy whereas family history of depression and personal history of premenstrual syndrome were significant risk factors. [ABSTRACT FROM AUTHOR]

Information on the safety of first-trimester exposure to diagnostic magnetic resonance imaging (MRI) remains scarce. We are reporting a case series of 15 consecutive pregnant women who underwent an MRI scan with a 1.5-Tesla scanner of either the head (n = 5), cervical spine (n = 4), lumbar spine (n = 4), pelvis (n = 1) or knee (n = 1) in their first trimester of pregnancy (mean gestational age at exposure: 3.8 weeks). Patients were prospectively followed up until the completion of their pregnancy. Two cases received gadolinium as a contrast agent. There were 15 babies born alive. Of them, one baby was born with the left kidney not visualised by ultrasound examination, and another one with an overlapping toe in the right foot. None of these abnormalities were considered by the authors related to the MRI exposure. In conclusion, our study provides support to published preliminary evidence regarding the safety of MRI in the first-trimester pregnant women. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on a pregnant women transfused with blood products inadvertently obtained from donors treated with acitretin.