Lifestyle Changes for Pregnant Rosaceans

The following information is excerpted from "Planning Your Pregnancy and Birth", a publication of the American College of Obstetricians and Gynecologists, as well as the "1998 Physicians' Desk Reference".

Harmful substances (Teratogens): Teratogens are substances which can cause birth defects when a woman is exposed to them during pregnancy. They include certain medications, chemicals, and infections. These agents can prevent the fetus from growing normally and cause defects of the brain or body.

Acne and Rosacea Medications: During pregnancy, changes in hormone levels can cause a variety of not-so-pretty (but temporary) skin problems. For example, you may find that your face breaks out more in acne during pregnancy. Many of the drugs, however, used to treat acne can be very harmful to a growing baby.

One of the most dangerous of such acne medications is isotretinoin, more commonly known as Accutane. If a mother-to-be is taking Accutane in any amount even for short periods of time, there is an extremely high risk that the child will be deformed. Major fetal abnormalities associated with Accutane include severe retardation as well as deformities of the brain, nerves, skull, face, eyes, and glands. Roche Laboratories, Inc., the makers of Accutane, maintain that women on Accutane should wait at least one month after treatment is completed before trying to become pregnant. Please be aware, however, that even after treatment (ingestion) is completed, Accutane lingers in body cells for approximately seven years. It has not been thoroughly studied or determined what effect past (>1 month) Accutane treatment may have on a growing fetus.

Also dangerous are any medications (or vitamins) containing unusually high quantities of vitamin A or vitamin A byproducts: etretinate, for example, or retinoids such as Retin-A and Renova. Very high levels of vitamin A have been linked to severe birth defects. Retinoids have been proven to cause severe birth defects in animals and are associated with human birth defects.

Corticosteroids such as DesOwen and Westcort also should be avoided by pregnant women. Corticosteroids have been consistently shown to cause birth defects in laboratory animals, even when only applied to the skin. There are as yet no adequate studies of their effect on human pregnancies; the manufacturers, however, recommend they be avoided by pregnant women unless specifically directed otherwise by a physician aware of the risk.

You should also avoid antibiotics unless specifically directed otherwise by an OB-GYN. Tetracycline, for example, can harm a growing fetus.

Tell all of your health care providers (e.g., your dermatologist, dentist, psychologist, emergency care, etc.) that you are pregnant. Also avoid over-the-counter drugs. Pain relief such as aspirin, acetaminophen, and ibuprofen may be harmful to your baby. Other potentially harmful drugs include laxatives, cold medicine, sleeping pills, and allergy remedies. Check with your doctor before using any over-the-counter drug; he or she should be able to specify which medications are or are not safe for pregnant women.

Other medications and substances to avoid:

• Androgens and testosterone by-products (for example, danazol)
• Angiotensin-converting enzyme (ACE) inhibitors (for example, enalapril or captopril)
• Coumarin by-products (for example, warfarin)
• Carbamazepine
• Anti-folic acid drugs (for example, methotrexate or aminopterin)
• Diethylstillbestrol (DES)
• Lead
• Lithium (for example, in anti-depression drugs)
• Organic mercury
• Phenytoin
• Streptomycin and kanamycin
• Tetracycline
• Thalidomide
• Trimethadione and paramethadione
• Valproic acid

Smoking:  Pregnant women should not smoke or use tobacco products. Women who smoke during pregnancy are much more  likely to have a miscarriage, stillbirth, or premature birth. Smoking also puts a fetus at a much higher risk of low birth weight, mental retardation, and deformed arms and legs.

Alcohol:  Alcohol is very harmful to a growing fetus. There is a pattern (fetal alcohol syndrome) of major physical, mental and behavioral problems in babies exposed to alcohol during pregnancy. Effects of alcohol include:

• Small bodies (even with special care, their growth does not catch up)
• Problems with joints and limbs
• Heart defects
• Abnormal facial features
• Behavioral problems, including hyperactivity, anxiety, and poor attention span.
• Smoking, drug use, poor diet and stress also may play a role in this condition.

Drugs:  All illegal drugs, including marijuana, should be avoided.

Nutrition:  Pregnant women should take care to eat a balanced diet consisting of a variety of healthy foods. That means daily servings of fruits and vegetables, whole-grain breads and cereals, milk and milk products, and high-protein foods such as fish, beans, meat and poultry. Ask your OB-GYN for more comprehensive information.

Water:  Drink at least 8 glasses of water a day. One tip to increase your fluid intake: keep a bottle of water on your desk or in your purse. Drink from it often. Water is used to:

• Build new tissue
• Carry nutrients and waste products within the body
• Aid digestion
• Help chemical reactions
• Form amniotic fluid around the fetus and help prevent the uterus from contracting before it should (premature labor).

Rest:  Get enough sleep. While you are sleeping, your body is hard at work building a whole new human being from scratch. Allow yourself more time to sleep than usual: at least 8 or 9 hours a night.

Work:  Some jobs may not be suitable for pregnant women: jobs which require strenuous labor, for example, or exposure to hazardous chemicals. Ask your OB-GYN about your work environment.

Medical Care:  See an OB-GYN frequently throughout the course of your pregnancy. OB-GYN specialists will be able to identify potential problems with your pregnancy, as well as help you choose healthy lifestyles.