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Effects of Drugs on the Fetus

The tragic consequences for the fetuses of pregnant women using the sedative thalidomide destroyed the theory that the placenta was a type of barrier protecting the fetus from the effects of maternal pharmacology. It now is known that virtually all drugs and chemical compounds cross the placenta. Because such compounds have to cross several lipoprotein barriers in vascular walls to travel from the maternal to fetal circulation, certain physicochemical characteristics of drugs and chemicals favor transport to the fetus: low molecular weight, lipid solubility, and nonionization at a pH of 7.4. Most drugs in current use (prescription and over-the-counter) cross the placenta. Most environmental toxins also cross the placenta and present a special problem; they are very lipid-soluble and may be stored in the woman's body fat, even from childhood until pregnancy occurs. With pregnancy may come mobilization and passage to the fetus. Details of when compounds are transferred across the placenta in pregnancy in humans are not available. Because we are unable to obtain more than the single simultaneous maternal and fetal samples available from the cord blood at delivery, our knowledge of maternal-fetal partitioning and pharmacokinetics remains fragmentary.

Drug exposure can occur at any time from conception through labor and delivery.

This article has been cited by other articles:

				P. Nair, S. Rothblum, and R. Hebel Neonatal Outcome in Infants With Evidence of Fetal Exposure to Opiates, Cocaine, and Cannabinoids Clinical Pediatrics, May 1, 1994; 33(5): 280 - 285. [Abstract] [PDF]