title: Perception of teratogenic risk and the rated likelihood of pregnancy termination: association with maternal depression.
abstract: OBJECTIVE
  Women are often exposed to various medications and medical conditions during pregnancy. Unrealistically high maternal teratogenic risk perception, related to these exposures, may lead to abrupt discontinuation of therapy and (or) termination of a wanted pregnancy. The association between maternal depression and the teratogenic risk perception has not been studied, nor were the actions resulting from this perception. Our objectives were to explore the association between maternal depression, teratogenic risk perception, and the rated likelihood to terminate pregnancy. Additionally, we evaluated possible benefits of counselling.
  
  
  METHODS
  We administered the Edinburgh Postnatal Depression Scale (EPDS) to all women who attended the Motherisk Clinic between October 2007 and April 2010. A visual analogue scale was used to determine maternal risk perception in relation to the specific exposure, and the rated likelihood to terminate the pregnancy, before and after counselling.
  
  
  RESULTS
  We analyzed data from 413 women. Maternal teratogenic risk perception and the rated likelihood to terminate the pregnancy were significantly lower following counselling. An EPDS score of 13 or more was significantly associated with a higher rated likelihood to terminate the pregnancy (P = 0.03). In a multivariable regression analysis, an EPDS score of 13 or more was found to be an independent predictor of a higher personal teratogenic risk perception (P = 0.03).
  
  
  CONCLUSIONS
  Both maternal depression and exposure-directed counselling are associated with maternal risk perception and the rated likelihood to terminate pregnancy. Appropriate counselling may reduce fear of teratogenicity and the likelihood of pregnancy termination.
authors.affiliation: The Motherisk Program, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Asnat
authors.initials: A
authors.lastname: Walfisch
authors.forename: Corey
authors.initials: C
authors.lastname: Sermer
authors.forename: Ilan
authors.initials: I
authors.lastname: Matok
authors.forename: Adrienne
authors.initials: A
authors.lastname: Einarson
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D003376:Counseling; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D018811:Maternal Exposure; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012306:Risk; D055815:Young Adult