Epidemiology of Reproductive Toxicology

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There are more than 90,000 chemicals used commercially in the United States, but only 2200 have been evaluated for mutagenic and teratogenic effects in animal models. There are more than 20 million women of reproductive age in the U.S. workforce, but only 4 to 6% of birth defects are related to known drug or toxin exposures during pregnancy. From 30 to 70% of pregnant women use three to ten different drugs during pregnancy, especially vitamins, iron, analgesics, antipyretics, antimicrobials, antiemetics, theophylline, caffeine, ethanol, and nicotine. From 15 to 25% of pregnant women report licit drug use (ethanol > nicotine), or illicit drug use (marijuana > cocaine > heroin), or have positive urine drug screens during pregnancy. Analgesics, vitamins, iron, antibiotics, theoph-ylline, and psychotropic medications account for 50 to 80% of all reported toxic ingestions by pregnant women.

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