• Julia Robertson, Janine E Polifka, Marina Avner, Christina Chambers, George Delevan, Gideon Koren, Sharon Voyer Lavigne, Lynn P Martinez, Richard K Miller, and John C Carey.
• Utah Department of Health, Division of Community and Family Health Services, Birth Defects and Genetics Program, Pregnancy RiskLine, Salt Lake City, 84114-4691, USA. jrobertson@utah.gov
• Birth Defects Res. Part A Clin. Mol. Teratol. 2005 Nov 1;73(11):881-7.

BackgroundIsotretinoin is a known human teratogen, causing birth defects and/or subnormal cognitive performance in prenatally-exposed children.MethodsA survey was conducted among women who called teratology information services throughout North America. Using a structured questionnaire, women with an isotretinoin-exposed pregnancy were prospectively interviewed before the outcome of the pregnancy was known.ResultsAlmost 1/4 of the women surveyed (24%; 8/34) did not recall having contraception counseling before starting their medications. Once therapy was initiated, 62% (21/34) recalled using a birth control method, but only 29% (6/21) recalled using 2 forms of birth control, as specified by the voluntary pregnancy prevention programs. Monthly pregnancy tests were not always conducted during treatment, as recalled by the surveyed women (56%; 19/34). As many as 24% (8/34) of the women surveyed recalled that they were not screened using 2 pregnancy tests before receiving a prescription, another recommendation of the programs. Only a small number of the women (30%; 6/20) in the United States recalled being enrolled in any manufacturers' voluntary pregnancy prevention survey.ConclusionsResults demonstrate that essential components of voluntary pregnancy prevention programs were not consistently followed, which resulted in fetal exposures.

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