08:37 AM PDT on Monday, July 26, 2004

Associated Press

KGW.com

SEATTLE - Although it is nearly common knowledge that taking illegal drugs while pregnant is a threat to the life of the fetus, much less is known about the impact of prescription drugs on pregnant women.

That is why CARE Northwest at the University of Washington, which gives free telephone advice about the possible effects of drug and chemical exposure during pregnancy, is poised to conduct a study on drugs during pregnancy, thanks to a new $2.8 million grant.

“The bottom line is many women need to take medications when they’re pregnant,” said Mary Hebert, associate professor of pharmacy and chief investigator for the study. “Physicians ... are doing the best they can, but it’s based on very little information.”

The five-year grant is unusual because it’s not for one particular study.

Rather, the UW will be one of the nation’s first federally funded research centers looking broadly at fundamental questions surrounding prenatal drug use, including identifying the body’s mechanisms for processing and responding to the drugs, Hebert said.

Eventually, the project will include testing specific drugs in hundreds of pregnant women and tracking the health and development of their children, she said.

The National Institute of Child Health and Human Development gave similar grants to Georgetown University, the University of Pittsburgh and the University of Texas, she said, adding, “They’re trying to develop expertise across the country.”

Scientists have been slow to develop such expertise, partly because testing pregnant women raises liability concerns, she said. Studying the impact of drugs on fetuses also is expensive and time-consuming, said Janine Polifka, co-director of CARE Northwest.

Scientists know that men and women react to drugs differently and that pregnant women react differently from other women. But until a decade or so ago, most drug studies were done on men. Even now, she said, women are not included equally, and pregnant women are still excluded.

Meanwhile, pregnant women and their doctors must struggle to decide: to medicate or not medicate?

Sometimes there’s danger either way—certain drugs may increase the risks of birth defects or miscarriage, but the lack of drugs also may threaten the fetus.

For example, a woman’s prolonged fever of 101 degrees or higher during the first six weeks of pregnancy can cause spina bifida or even kill the fetus, according to the Organization of Teratology Information Services, of which CARE Northwest is a member.

But one of the most common fever remedies, ibuprofen, has been linked to an increased risk of miscarriage early in pregnancy, according to OTIS, which cites conflicting studies on the subject.

CARE Northwest takes about 75 calls a week from women or their doctors throughout Washington, Oregon, Idaho and Alaska. Many of the calls are from women who just learned they’re pregnant, which usually doesn’t happen until the fifth or sixth week of pregnancy, Polifka said.