Oral Histology & Development

Pregnancy and Lifestyle
(Side Effects)

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1.    Smoking
  • Maternal hypertension 
  • Decreased uterine blood flow 
  • Fetal hypoxemia 
  • Uterine contractions 
  • Placental abruption 
  • Increased rates of stillbirth, placental abruption, symmetric IUGR, and preterm delivery
  • Increased rates of Sudden Infant Death Syndrom (SIDS)

2.    Alcohol and caffeine
  • Negative effect on fetal growth rate 
  • Has a relation to mild neurodevelopmental handicaps 
  • Attributable to intrauterine growth retardation(IUGR) 
  • Smoking during pregnancy affects children even after birth 
  • Cognitive deficits and developmental problems in childhood 

3. Environmental Factors


Chemicals:
  • Analgesic
  • Anticoagulants
  • Anticonvulsants
  • Antimicrobial

Infectious:
  • Rubella effects congenital defects of heart, eyes and tears
  • Syphilis effects fetal death, anemia, jaundice,
  • Toxoplasmosis effects abortion, intrauterine growth retardation, jaundice.
  • Radiation
  • Mechanical factors
  • Temperature
  • Nutritional factors
  • Maternal health
  • Parental age

4. Drugs
      

About 2 to 3% of all birth defects result from the use of drugs other than alcohol.
  • Act directly on the fetus, causing damage, abnormal development (leading to birth defects), or death
  • Alters the function of the placenta, usually by causing blood vessels to narrow (constrict) and thus reducing the supply of oxygen and nutrients to the fetus from the mother. Sometimes the result is a baby that is underweight and underdeveloped
  • Cause the muscles of the uterus to contract forcefully, indirectly injuring the fetus by reducing its blood supply or triggering preterm labor and delivery


Some Drugs That Can Cause Problems During Pregnancy 

Antianxiety drug

Diazepam
  • When the drug is taken late in pregnancy, depression, irritability, shaking, and exaggerated reflexes are possible in the newborn

Antibiotics
Chloramphenicol
  • Gray baby syndrome: In women or fetuses with glucose-6-phosphate dehydrogenase (G6PD) deficiency, it causes the breakdown of RBCs

Fluoroquinolones 
  • such as Ciprofloxacin, Ofloxacin, Levofloxacin, and Norfloxacin 
  • Possibility of joint abnormalities (seen only in animals)

Kanamycin
  • Damage to the fetus's ear, resulting in deafness

 Nitrofurantoin
  • In women or fetuses with G6PD deficiency, results in the breakdown of RBCs

Streptomycin
  • Damage to the fetus's ear, resulting in deafness

Sulfonamides
  • Such as Sulfasalazine and Trimethoprim Sulfamethoxazole
  • When the drugs are given late in pregnancy, jaundice and brain damage in the newborn may occur (much less likely with sulfasalazine).
  • In women or fetuses with G6PD deficiency, results in the breakdown in RBCs

Tetracycline
  • Slowed bone growth, permanent yellowing of the teeth, and increased susceptibility to cavities in the baby
  • Occasionally, liver failure in the pregnant woman

Anticoagulants


Heparin
  • When the drug is taken a long time, osteoporosis and a decrease in the number of platelets (which help blood clot) in the pregnant woman

Warfarin
  • Birth defects
  • Bleeding problems in the fetus and the pregnant woman

Anticonvulsants
Carbamazepine
  • Some risk of birth defects
  • Bleeding problems in the newborn, which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth

Phenobarbital 
  • Some risk of birth defects
  • Bleeding problems in the newborn, which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth

Phenytoin
  • Some risk of birth defects
  • Bleeding problems in the newborn, which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth

Trimethadione
  • Increased risk of miscarriage in the woman
  • High (70%) risk of birth defects, including a cleft palate and defects of the heart, face, skull, hands, or abdominal organs
 
Valproate
  • Some (1%) risk of birth defects, including a cleft palate and defects of the heart, face, skull, spine, or limbs

Antihypertensives
  • Angiotensin-converting enzyme (ACE) inhibitors 
  • When the drugs are taken late in pregnancy, kidney damage in the fetus, a reduction in the amount of fluid around the developing fetus (amniotic fluid), and defects of the face, limbs, and lungs

Beta-blockers
  • When some beta-blockers are taken during pregnancy, a slowed heart rate and low blood sugar level in the fetus and possibly slowed growth

Thiazide diuretics
  • A decrease in the levels of oxygen, sodium, and potassium and in the number of platelets in the fetus's blood
  • Slowed growth


Chemotherapy drugs
Actinomycin
  • Possibility of birth defects (seen only in animals)

Busulfan
  • Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot
  • Slowed growth

Chlorambucil
  • Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot
  • Slowed growth
 
Cyclophosphamide
  • Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot
  • Slowed growth

Mercaptopurine
  • Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot
  • Slowed growth

Methotrexate
  • Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot
  • Slowed growth

Vinblastine
  • Possibility of birth defects (seen only in animals)

Vincristine
  • Possibility of birth defects (seen only in animals)

Mood-stabilizing drug
Lithium 
  • Birth defects (mainly of the heart), lethargy, reduced muscle tone, poor feeding, underactivity of the thyroid gland, and nephrogenic diabetes insipidus in the newborn
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Aspirin and other salicylates
  • When the drugs are taken in large doses, a delay in the start of labor, premature closing of the connection between the aorta and artery to the lungs (ductus arteriosus), jaundice, and (occasionally) brain damage in the fetus and bleeding problems in the woman during and after delivery and in the newborn
  • When the drugs are taken late in pregnancy, a reduction in the amount of fluid around the developing fetus

Oral antihyperglycemic drugs
Chlorpropamide
  • A very low level of sugar in the blood of the newborn
  • Inadequate control of diabetes in the pregnant woman
  • When the drug is taken early in pregnancy by a woman with type 2 diabetes, possibility of increased risk of birth defects

 Tolbutamide
  • Same as those for chlorpropamide 

Sex hormones
Danazol
  • When this drug is taken very early in pregnancy, masculinization of a female fetus's genitals, sometimes requiring surgery to correct

Diethylstilbestrol (DES)
  • Abnormalities of the uterus, menstrual problems, and an increased risk of vaginal cancer and complications during pregnancy in daughters
  • Abnormalities of the penis in boys


Skin treatments
Etretinate
  • Birth defects, such as heart defects, small ears, and hydrocephalus (sometimes called water on the brain)
            
Isotretinoin
  • Mental retardation
  • Risk of miscarriage

Thyroid drugs
Methimazole         
  • An enlarged or underactive thyroid gland in the fetus
  • Scalp defects in the newborn

Propylthiouracil
  • An enlarged or underactive thyroid gland in the fetus

Radioactive iodine
  • Destruction of the thyroid gland in the fetus
  • When the drug is given near the end of the 1st trimester, very overactive and enlarged thyroid gland in the  fetus

Triiodothyronine
  • An overactive and enlarged thyroid gland in the fetus

5.   Herbs
      

Herbs, such as Queen Anne's Lace seeds, Vitamin C, Rue/Rutin, or Cotton Root Bark
  • Block, alter, or interfere in the production of progesterone. The lining of the uterus does not grow enough to be supportive or nourishing to a fertilized egg; thus preventing implantation.
  • The connection not being made, the egg begins to break down along with the uterine lining, menstruation occurs and may be normal to heavy.
  • It should be noticed that these herbs not always cause abortion, if they didn’t you must seek for surgical intervention for abortion because the fetus will definitely be underdeveloped or have some defects.

6.   Perfumes
  • The smell of perfumes and colognes can be overwhelming.
  • The toxic effects of fragrances can also be overwhelming.
  • Acetaldehyde is a probable human carcinogen. It crosses the placenta to a fetus. The chemical substance will cause headaches, tremors, convulsions, and even death as a possible effect of exposure to it.
  • The common disorders of the reproductive system that affect newborn boys (incomplete testis descent; hypospadias - a disorder in which the opening of the urinary tract on the penis is misplaced) or young adult men (low sperm counts, infertility) may all have their origins during fetal development. It’s maybe caused by the chemical substance present not only in perfumes but in air, food, beauty products and house cleaners.
  • Phthalates are toxins that are used in some perfumes. Phthalates are being tested for their effect on pregnancy, but no definitive results have been released. Potential side effects from chemical based perfume can include skin, hormonal and respiratory problems.