Reducing the Risk of Preventable Birth Defects

While over 20% of congenital malformations are genetically caused, a similar number are thought to be multifactorial in origin and the cause of over 50% of malformations remains unknown (Toufaily et al., 2018). MotherToBaby helps geneticists identify modifiable risk factors for birth defects, giving you the chance to educate your patients to take preventative action. We can assist you by surveying the current scientific literature on environmental exposures of interest and provide you and your patient with evidence-based summaries of risk potential during pregnancy and lactation. This information can serve to lessen worry for people about necessary or accidental exposures during pregnancy or while breastfeeding.

Although genetic factors contribute to birth defects risk, environmental (i.e., non-genetic) factors influence the risk for birth defects as well. Some of these environmental risk factors are recognized as strong teratogens, such as maternal rubella infection and use of the medications thalidomide or isotretinoin during pregnancy. Identification of environmental teratogens provides an opportunity for prevention activities.

— Tinker et al., 2015

Explore how we can help you and your pregnant and breastfeeding patients by providing no-cost exposure risk assessments, patient education materials, observational studies to monitor pregnancy outcomes, and more.

Make Informed Decisions for Treating Patients with Allergic and Immunologic Conditions

MotherToBaby supports allergists and immunologists in managing maternal health conditions like asthma, allergies, and atopic dermatitis. We understand the challenges that you face when deciding on treatment courses when your patient is pregnant or breastfeeding. Our resources will help you weigh the risks and benefits to both your patient who is pregnant and their baby as you determine a treatment plan that maximizes disease management and minimizes maternal and fetal/infant risk. 

We are also dedicated to furthering the information and understanding of medication safety in pregnancy through our observational MotherToBaby Pregnancy Studies. We are proud to lead more than half of all Food and Drug Administration (FDA)-mandated pregnancy registries conducted in the U.S., including studies on asthma and atopic dermatitis treatments. MotherToBaby Pregnancy Studies are rigorously designed cohort studies that aim to provide critically needed product safety information – and your patient referrals make all the difference. With your referral, you are helping us generate data that will lead to improved product safety information in pregnancy, thereby providing you and your patients with the evidence you need to make more informed treatment decisions.

In the U.S., 20% of [people who are pregnant] are affected by allergies, especially rhinitis and asthma.

— World Allergy Organization

Explore how we can help you and your pregnant and breastfeeding patients by providing no-cost exposure risk assessments, patient education materials, observational studies to monitor pregnancy outcomes, and more.

Partners

• Allergy & Asthma Network
• American Academy of Allergy, Asthma & Immunology
• Society for Maternal-Fetal Medicine
• Society for Birth Defects Research & Prevention
• Patient Education Genius
• PatientsLikeMe
• The Mighty

Can you guess the leading cause of infant hospitalizations in the United States? You might think accidents, allergic reactions, or the flu, but the answer is actually respiratory syncytial virus (RSV). Every year, RSV sends 58,000 to 80,000 children under the age of 5 to the hospital.

Having a baby in the fall or winter has always meant that parents need to be extra careful about RSV. Fortunately, in 2023 two new ways to protect infants against this virus became available: a vaccine given to women between 32 and 36 weeks of pregnancy and an antibody (passive immunization) that is given directly to babies after birth. Today, we’re covering some of the most common questions we get at MotherToBaby about RSV prevention.

Q: What is the maternal RSV vaccine? When is it given?

The maternal RSV vaccine (brand name Abrysvo^®) is a protein subunit vaccine (it contains proteins the body needs to make antibodies against RSV). The vaccine does not contain live virus that can cause RSV. When a woman gets the RSV vaccine during pregnancy, the antibodies she makes can also pass to the developing fetus. These antibodies can help protect the baby from RSV during the first 6 months of life.

The Abrysvo^® RSV vaccine can be given to women who are 32 to 36 weeks pregnant who have not received a maternal RSV vaccine in a previous pregnancy. The RSV vaccine is only recommended for use during pregnancy between September and January in most of the United States. 

Q. What is an infant RSV antibody? When is it given?

Infant antibodies, also called passive immunizations, are another effective way to help protect babies from RSV. Two RSV antibodies are currently available: nirsevimab (Beyfortus®) and clesrovimab (Enflonsia®). The RSV antibody is recommended for infants younger than 8 months who are entering their first RSV season if their mothers did not receive the maternal RSV vaccine during pregnancy. Infants and children ages 8 to 19 months who are at high risk for severe RSV illness and entering their second RSV season may also be eligible for the antibody. The RSV antibody is available between October and March for most of the United States and starts working immediately after it is given.

For more information about timing, eligibility, and benefits of infant RSV antibodies, talk with your child’s pediatrician.

Q: Is one of these options better than the other?

Patients can choose either the maternal vaccine or the infant antibody. Both are great options for protecting infants against RSV, and there is currently no preference for one over the other. A slight benefit of getting the RSV vaccine during pregnancy is that most babies will be born with immediate protection if the vaccine is given at least 2 weeks before delivery. Some parents might also prefer the maternal vaccine because it avoids an extra injection (shot) for the baby.

Q. How do we know the RSV vaccine is ok to get in pregnancy?

Studies on the Abrysvo^® RSV vaccine have not found a higher chance of birth defects. It’s also reassuring to note that the vaccine is given in the third trimester (between 32 and 36 weeks), which is past the critical period when most birth defects could happen.

Early clinical trials on the vaccine observed slightly more preterm births in women who received the Abrysvo^® RSV vaccine than in those who did not (5.7% in the vaccinated group vs. 4.7% in the placebo group). However, newer data from larger studies has not found a higher chance of preterm birth following RSV vaccination in pregnancy. Check out the MotherToBaby RSV vaccine fact sheet for more information on this topic.

Q. If I got an RSV vaccine in my last pregnancy, do I need to get it again in my next pregnancy?

The simple answer is no. At this time, the maternal RSV vaccine is only recommended for women who have not gotten it in a previous pregnancy. Researchers need time to determine if getting the vaccine once can provide ongoing protection for future pregnancies, or if a booster dose is needed in every pregnancy.

If you received the RSV vaccine during a previous pregnancy and are pregnant again, your baby can get an infant RSV antibody to help ensure they are protected.

Making Your Choice

No matter whether you decide on the maternal RSV vaccine or an infant RSV antibody, you’re making a great choice to protect your baby from RSV! Still have questions? Remember that MotherToBaby can be reached by chat, text, phone, or email with questions about the RSV vaccine or any other exposure in pregnancy or while breastfeeding.

BRENTWOOD, TN – January 28, 2015

Approximately 50% Of Women Report Taking At Least One Medication During Pregnancy
As January’s National Birth Defects Prevention Month comes to a close, the United States’ Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA) opens the door for expanded access to pregnancy health education resources by funding the world’s leading organization of experts in the field of teratology (the study of exposures that cause birth defects) – the Organization of Teratology Information Specialists (OTIS) MotherToBaby network.

OTIS, an international non-profit, has been awarded a two-year, $2.4 million cooperative agreement from HRSA, establishing a nationwide reproductive and environmental health network. The MotherToBaby network, which consists of 14 affiliate OTIS sites housed at universities and hospitals across the country, provides FREE, evidence-based, personalized risk assessments, education and counseling regarding the effects of exposures like prescription and over-the-counter drugs, alcohol, smoking, illicit substances, vaccines, beauty products, herbal supplements, chemicals and more during pregnancy and while breastfeeding.

“Approximately 50% of women report taking at least one medication during pregnancy and may be doing so before they even realize they’re pregnant,” said Kenneth Lyons Jones, MD, MotherToBaby past president. “Instead of having to scour unreliable online message boards and websites for information about a medication’s risk to a developing baby, they can talk directly to an expert in this topic who will have the most up-to-date research available to them,” he explained.

More than 100,000 women and their health care providers seek information about birth defect prevention from MotherToBaby every year already. The new federal support is expected to help increase awareness of the expertise MotherToBaby has to offer among women and health care providers in more hard-to-reach populations.

“Not only is this is a huge step forward for women and children’s health, but also the general public’s, since it’ll allow us to staff increased calls, answer more questions and, ultimately, prevent birth defects, leading to a healthier society,” said Jones, who is also one of two doctors who discovered Fetal Alcohol Syndrome (FAS) in 1973. “With a broader presence, we’ll also be able to better educate new audiences about dangerous behaviors like drinking alcohol during pregnancy.”

Partner organizations, such as Help Me Grow Utah, have applauded HRSA’s move to provide funding to the MotherToBaby network. “At Help Me Grow Utah, an affiliate of the Help Me Grow National Network, we understand the challenge of funding. Through a new cooperative agreement with HRSA, all women have been provided access to the MotherToBaby’s hotline, with the latest information about risk exposures during pregnancy and breastfeeding. The result is improved health for moms and their babies, which helps put infants on track for reaching optimal development, a goal we wholeheartedly support,” said Barbara Leavitt, Program Director of Help Me Grow Utah.

The public can be connected with bilingual (English/Spanish) teratogen information specialists at MotherToBaby and receive personalized risk assessments, education and counseling by calling toll-free 1-866-626-6847. The MotherToBaby website also houses a library of fact sheets on medications and other exposures during pregnancy and while breastfeeding located at https://mothertobaby.org//a>.

Media Contact: Nicole Chavez, 619-368-3259, nchavez@mothertobaby.org. Interviews in Spanish can also be arranged.

BRENTWOOD, TN – Experts at MotherToBaby, a service of the international non-profit Organization of Teratology Information Specialists (OTIS), call the recent New York Times article suggesting use of antidepressants during pregnancy is more harmful than previously thought “incomplete” and “weak.” The story takes a strong stance suggesting depression treatments during pregnancy may lead to more birth defects. “This kind of information can scare women into taking drastic measures, like stopping her medication suddenly,” said Julia Robertson, teratogen information specialist and MotherToBaby/OTIS Board of Director member. “The article fails to include the overwhelming research that supports treating mental illness during pregnancy, which may be a contributor to healthier pregnancy outcomes, compared with women who stop their treatment cold turkey,” she added.

The MotherToBaby/OTIS BOD strongly supports two responses to the NY Times article:

http://womensmentalhealth.org/posts/response-new-york-times-article-ssris-pregnancy-moving-toward-balanced-view-risk

http://www.huffingtonpost.com/seleni-institute/the-new-york-times-irresp_b_5761090.html

In addition, the MotherToBaby issued the following statement Monday to mothers and those planning pregnancies, in which the article has caused unnecessary anxiety:

To Concerned Moms,

Each day members of the Organization of Teratology Information Specialists (OTIS), experts behind the MotherToBaby service, review the new information on medications that are used in pregnancy and while breastfeeding. When we look at the research studies we look at how well each study was done and we note the strengths and weaknesses. Many studies are done well, but many are not. The recent article on antidepressant use in pregnancy from the New York Times did not give a careful and a complete review of all the available studies. In looking at all the studies that have been completed in the last 30 years with more than 100,000 pregnancies in which the mother used an antidepressant, we conclude that if there is a risk for a birth defect, the risk is very low.

The experts at MotherToBaby are here to talk with you about the medications you are taking and to provide you with the most up-to-date information and research. Hundreds of women and their health care providers seek information about birth defect prevention from OTIS and MotherToBaby every year. Our personalized, FREE counseling service is just a phone call away at 1-866-626-6847.

You can also view our Fact Sheets,(under the Resources button) which summarize information about antidepressant use in pregnancy and breastfeeding.

Sincerely,

OTIS Board of Directors along with the OTIS Website and Public Affairs Committees.

MotherToBaby’s expertise is suggested by many agencies including the Centers for Disease Control and Prevention (CDC).