Appetite suppressants in pregnancy.
OBJECTIVE
Both, obesity as well as anorexia may be associated with infertility and other complications of pregnancy. Weight loss during pregnancy is therefore considered a risk factor. Weight loss and appetite suppressant are contraindicated during pregnancy, but the unintended exposure is probably not associated with higher risk. Our work was focused on trends in the appetite suppressants use in the Czech Republic and their embryotoxicity.


METHODS
The pregnancies exposed to various appetite suppressants were followed prospectively in the years 1997-2012. The study group was compared to the comparison group which enrolled pregnant women exposed to non-teratogenic drugs. Drugs used as appetite suppressants were sibutramine and phentermine.


RESULTS
Number of calls for this type of exposure was rare till 2005. Their number started to increase until 2009. Later, number of calls decreased because both drugs were withdrawn from the market. This finding reflects increasing tendency for the weight control in the group of fertile women in the Czech Republic. In our study, we did not reveal differences in pregnancy outcomes between study and comparison groups.


CONCLUSIONS
However, we should be aware of the increasing food supplements exposure, that could be used as alternative to the appetite suppressants. Their potential risk results from the limited or completely absent control of their origin. Some of them have probably only placebo effect, but some of them could represent the risk.
Department of Histology and Embryology, Charles University, Prague, Czech Republic. eva.manak@post.cz
Eva
E
Manakova
Tereza
T
Kralova
Lucie
L
Hubičková Heringová
D000015:Abnormalities, Multiple / Q000453:epidemiology; D000022:Abortion, Spontaneous / Q000453:epidemiology; D001067:Appetite Depressants / Q000009:adverse effects* / Q000627:therapeutic use; D003503:Cyclobutanes / Q000009:adverse effects* / Q000627:therapeutic use; D018153:Czech Republic / Q000453:epidemiology; D016208:Databases, Factual / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009765:Obesity / Q000188:drug therapy* / Q000453:epidemiology; D010645:Phentermine / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011261:Pregnancy Trimester, First; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D001067:Appetite Depressants; D003503:Cyclobutanes; D010645:Phentermine; C058254:sibutramine