지난 9월 28일
제 18 차 서울국제심포지움이 서울 힐튼 호텔에서 열렸다.
연자로 Teratology Information Service in Korea: MotherSafe center에 대한
소개를25분 동안 하였다. 토요일 오후여서 그런지 학회장이
활기 차지는 않았지만 발표할 수 있는 기회가 되어서 도움이 되었다고 생각한다.
내용은 아래와 같다. 강의 끝에 좌장님의 질문이 있었다.
질문 내용은 임신부가 주요기형유발물질에
노출되는 경우 현재 우리나라의 모자보건법에서 임신중절을 금하고 있는데 임신중절을 권하는지 여부였다.
답은 우리는 임신부와 가족에게 객관적으로 약물의 기형위험성정보만을 제공한다고 말씀 드렸다.
Service in Korea: MotherSafe Center
Jung Yeol Han
Korean MotherSafe Center, Cheil General Hospital and Women’s Healthcare Centre, Kwandong
University School of Medicine, Seoul,
MotherSafe Center is a Teratology
Information Service (TIS) for providing evidence-based information about the safety
and risks of a variety of exposures that may occur during pregnancy and
lactation. The MotherSafe Center was initially established in Seoul, at the Samsung
Cheil Hospital in 1999, and has been supported by the Korean Health and Welfare
Ministry since 2010. Since then, 5 centers have been added to a network,
including Busan, Gwangju, Daejon, Daegu, and Changwon. The MotherSafe Center is
also connected with the International Society of TIS (MotherToBaby;
Over the last 3 years, we have
received >19,000 telephone calls, approximately 70% were from pregnant women
and 30% from breastfeeding women. Data from callers including sociodemographic
characteristics and exposures such as drugs, alcohol, cigarette smoking are collected
in our database system and used for studying the safety and risk of drug
exposure during pregnancy and lactation. Privacy protection and confidentiality
are key characteristics of our center, which delivers an additional level of
comfort to patients who contact us.
In this presentation, I would like to
present about teratogenic risk counseling in pregnant women:
In Korea, approximately 50% of pregnant
women are unplanned. Therefore, many pregnant women are inadvertently exposed
to drugs, chemicals, smoking and radiation. Once they become aware of their
pregnancy, patients look for information on the risks of birth defects that
might be associated with their exposure. Some pregnant women would choose pregnancy
termination even if their exposures were to nonteratogenic exposures, due to
misinformation and risk misperception. Our center has been providing
evidence-based information on the safety and risks of exposure to drugs,
chemicals or physical agents. In our experience, this reduces the anxiety and
prevents unnecessary pregnancy terminations. We also have extensive experience in
providing teratogenic risk counseling on major teratogens such as isotretinoin,
misoprostole, acitretin, and valproate.
According to the Korean MotherSafe
preliminary data, pregnancy termination occurs in 4.7% (n= 18/382) of pregnant
women. Exposure to isotretinoin is responsible of 27.7% of terminations, common
cold drugs of 16.6%, antidepressants of 11%. However, our data show that adverse
pregnancy outcomes including malformation, preterm birth, and low birth weight
are not significantly different between exposed patients (n= 2,977) and
non-exposed women (n= 2,573).
In conclusion, our Center is
successfully helping Korean mothers, their
families and doctors, in making the right decision about medications,
chemicals, smoking and radiation in pregnancy and lactation. Therefore, efforts
to continue with the program provided by the MotherSafe Center and its network
should be made, and if possible should be extended to be accessible to any
Korean pregnant women with the sufficient support from our government.