Thalidomide

Phocomelia is a birth defect that is characterized by the malformed appendages, similar to a seals flippers. Phocomelia. Here is a table of the occurrence of phocomelia in the hospitals of Hamburg, Germany:

The drug thalidomide was marketed worldwide as a sedative that was safe for humans during pregnancy. Here is the overall story, including that of a brave person. The rest of the story is a little more complex. It turns out the drug had been heavily tested. Why did its dark nature not show up? Here's a paper that presents an analysis of the testing options. Read the Historical background then skip to Species specificity. [There is some conflict in the literature if thalidomide was tested in pregnant animials. This article say it had no effect on pregnant rats.

DES, diethylstilbestrol

DES was a drug given to pregnant women who were at high risk of miscarriage. Between 5 and 10 million women received the drug. There was no special ill effects originally noted in the mothers who took the chemical, but later reseach has indicated they may have higher rates of some cancers. But the daughters had unusually high rates of a vaginal cancer, clear-cell adenocarcinoma. This cancer is rarely seen in women under 50 years of age, and had never been reported in a woman under 30, until 7 young women, age 15 to 22 were diagnosed with the disease in a few years. This lead to an investigation that indicated DES was the culprit. Here's some more. DES Fact Sheet. In addition to the cancer, a variety of reproductive tissue defects are found. For example vaginal adenosis was found in 35% of the daughters of mothers who used DES, compared to 1% of control subjects.

Now the rest of the story. The cancers attributed to DES is in fact quite rare: http://jama.ama-assn.org/cgi/content/abstract/280/7/630?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=DES+&searchid=1097374896484_2841&stored_search=&FIRSTINDEX=0 5 to 10 million women took the drug during pregnancy. That means there are millions of women who are their daughters and are today middle-aged. The law of averages dictates that many of these women will have reproductive tract problems, and certainly would have had them regardless of their mothers' use of DES. What is a source of tragedy for a few, discomfort and insecurity for many, is a godsend for lawyers. Do a simple web search under DES, lawyers, and cancer and find thousands of web sites, either frankly by lawyers or though shill sites "friends of...." etc. It is a lucrative field, because virtually any reproductive system complaint by progeny of women who took DES will result in a settlement. The entire situation becomes more absurd, because careful study later revealed that DES was in fact not much use in preventing miscarriages in the first place.

There are at least two theories of the pathogenesis of DES induced cancer. One is that DES was an "in utero carcinogen" that increased the mutation rate of the developing reporting tissue in the female embryo. The second is that it was interfered with the develop of the vaginal tissue. The vagina tissue of DES daughters is often deranged, and this leads to mitogenesis due to irritation, etc.

Alcohol and Cocaine

Chronic alcohol ingestion during pregnancy can result in fetal alcohol syndrome (FAS). Cocaine use results in birth defects 2 to 3 times higher than the norm. One researcher found 6% of cocaine exposed infants had congenital malformations. I don't want to belabor these, substance use and abuse is characterized by extreme and vocal views. But my opinion is that use of alcohol and drugs is certainly associated with birth defects and this effect increases with increasing maternal drug use.

End of submodule

Module 6 Index