Q&A: Is there a way to tell if my unborn baby was affected by Accutane?

by Dr. Gerard M. DiLeo

I became pregnant while on Accutane, which can cause birth defects. Is there a way to tell whether my baby is affected? What is the percentage of birth defects?

Accutane, a brand name for Isotretinoin, is a derivative of Vitamin A and is used for acne. Yes, it can cause severe birth defects. For this reason, contraception is absolutely mandatory while on this drug. But since no contraception is perfect, there have, in fact, been many women in your predicament.

There were 154 such pregnancies reported just in the first two years after introducing Accutane. Of these, 95 were electively aborted, so I can't comment on what would have happened to these babies. Of the 59 pregnancies remaining, there were 12 spontaneous miscarriages, which is a miscarriage rate of only 13 percent. This isn't much different than the general population.

Of the 47 remaining pregnancies, 26 (55 percent) were born without major defects, although it's unknown at what gestational age exposure occurred. 21 (45 percent), however, had major malformations (three were stillborn and another died after birth).

Defects involved the central nervous system, deformities of the skull and face, heart and blood vessels, the liver, as well as other defects.

A Level Three ultrasound may be helpful in determining whether structural defects are present. However, the ultrasound may not show whether there are problems that are too masked to be revealed until after the baby is born. Your obstetrician can refer you to a specialist in Maternal-Fetal Medicine (a perinatologist), who can assign further perspective based on the weeks of exposure.

This is the hardest reply I've ever had to write for BabyZone. There's nothing I can tell you to make it sound any better. But you wanted information and here it is. You're in the biggest jam of your life and will be making the most important decision of your life as well. My thoughts and prayers are with you. Let me know what happens.

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