Hormonal Contraceptives: What if Exposed During Pregnancy?

• Main Authors: Duygun Altıntaş Aykan, Yusuf Ergün
• Format: Article
• Language: English
• Published: KARE Publishing 2019-03-01
• Series: Erciyes Medical Journal
• Subjects: contraception; teratogens; abnormalities; drug-induced; pregnancy
• Online Access: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-56514

Objective: Hormonal contraceptives are contraindicated in pregnancy. However, some women may become pregnant while using contraceptives to prevent pregnancy. In addition, these hormones may be used for abnormal uterine bleeding or secondary amenorrhea. In the present study, we evaluated the fetal outcomes of pregnant women who were inadvertently exposed to hormonal contraceptives during anytime in pregnancy. The aim of the present study was to expand the data about contraceptives with regard to their potential teratogenic effects. Materials and Methods: We collected data of pregnant women who were admitted to the Teratology Information Service (TIS) between 2014 and 2018 with hormonal contraception exposure during pregnancy. Data about medications, exposure to other agents, and comorbidities were documented. We analyzed the exposed drugs with respect to their potential teratogenic effects. Follow-up was conducted with women after delivery to determine whether any major or minor congenital malformations or adverse neurodevelopmental effects occurred in infants. Results: A total of 25 pregnant women who were admitted to the TIS for inadvertent use of hormonal contraception during pregnancy were included in the study. After delivery, we found that one female baby, who was exposed to medroxyprogesterone acetate in utero, had exitus postnatally in the first week of life. Three infants with maternal exposure to medroxyprogesterone acetate, dydrogesterone, estradiol valerate+norgestrel, and ethinyl estradiol+gestodene were born preterm. Among the three infants, two with maternal exposure to medroxyprogesterone acetate and ethinyl estradiol+gestodene had low birth weight. On the other hand, we found that 75% of the infants delivered were female. Conclusion: Contraceptive hormones presented no major teratogenic effects. However, avoidance of hormonal exposure and discontinuation whenever possible during pregnancy are suggested.