The perception of teratogenic risk by women with nausea and vomiting of pregnancy

Since the thalidomide disaster, pharmacologic management of disease in pregnancy is approached with caution. This study investigated 1) how advice received regarding management of nausea and vomiting of pregnancy (NVP) affects teratogenic risk perception, and 2) determined the effect of counseling on malformation risk perception in women with NVP. Women with NVP were counseled on the safety of anti-emetics for NVP. Participants were followed-up prospectively regarding the use of pharmacotherapy or other treatments, as well as their perception of teratogenic risk for anti-emetics. At the initial call, over 60% of the 260 participants reported therapy for NVP increased their teratogenic risk. This risk was decreased significantly after counseling (65.8% vs 42.3%, p<0.05). Women advised by their physicians to change their diet and/or lifestyle attributed an increased risk for malformations with anti-emetics (p=0.001). Women advised to take anti-emetics known to be safe to the fetus attributed no change in risk for malformations (p=0.002). Women are commonly hesitant to treat NVP due to unfounded fears of teratogenic risk. An evidenced-based approach to counseling may effectively alleviate such fears.