Teratogen Update: Environmentally Induced Birth Defect Risks

Our society's expectations of perfect babies, coupled with a belief that someone should be held responsible for birth defects, makes legal action on behalf of congenitally malformed infants common. In some instances the alleged cause of the malformation is exposure to drugs, industrial chemicals, radiation, or infectious agents. A convenient source of pertinent information on the etiology, pathogenesis, and prevention of teratogen-induced birth defects may be most welcomed by those concerned with the health of pregnant women and their offspring, epidemiologists in the field of perinatology, and health care professionals practicing "defensive medicine." While almost all the information in this book is available from other publications, this text compiles a wealth of information in a neat package. This slim volume contains reprints of 29 "Teratogen Update" reports which have appeared in Teratology since 1975, together with four articles from other sources. Some of the articles have been updated since their original publication. Others, not necessarily those published most recently, are unchanged. There are numerous references and, in several instances, these references have been updated considerably since the article first appeared. The first section of the book includes chapters on chemical, infectious, and drug-induced birth defects as well as the teratogenicity of cigarette smoke, diabetes mellitus, iodine deficiency, and hypothermia. There are numerous black-and-white photographs illustrating the classic features of the birth defects described and physical and histological examinations where appropriate. Well-designed charts of case series and reviews of the literature are included with some articles. The second, shorter section of the book deals with teratogens in a more general way. It contains very interesting advice for the expert witness and should be required reading for any epidemiologist or health care provider required to testify in court. Other papers of a general nature include case histories of lawsuits involving alleged teratogens, recommended categorization of drugs in terms of their possible effect on the fetus, and the scientific investigation of alleged teratogens. For those without ready access to the original sources of these articles and others who want a convenies>t compendium of teratogens and their effects, this book may be a welcome addition to their libraries. MAUREEN E. BRADY Graduate Student Department ofEpidemiology and Public Health Yale University School ofMedicine