Advice centre for medication during pregnancy and breastfeeding
Scientific focus on reproductive toxicology
Reproductive toxicology is concerned with the effects of potentially harmful factors (e.g. drugs, workplace and environmental chemicals) on the fertility of the parents and the development of the child during pregnancy and breastfeeding. Drugs can have fatal effects, especially in the first trimester of pregnancy, as the thalidomide scandal has shown. In addition to counselling, we have been involved in pharmacovigilance in the field of reproductive toxicology for over 25 years.
We use a special database system to record information on the consequences of exposure to drugs or harmful substances. This enables us to provide you quickly and comprehensively with up-to-date information on the use of medicines during pregnancy and breastfeeding as well as on environmental factors that are harmful to reproduction.
Contact & Advice
You can reach us by phone:
Mon to Thu: 08.00 - 18.00
Fri: 08.00 - 16.00
- Is there an increased risk of malformations after taking certain medications during pregnancy?
- Which medications can be taken during pregnancy if you wish to have children and have chronic illnesses?
- What are the risks following exposure to radiation, infectious diseases and contact with workplace and environmental chemicals during pregnancy?
- What possibilities does prenatal diagnosis offer for assessing the risk to the unborn child?
- Can the paternal use of medication before conception also cause problems for the child?
- Is it possible to reconcile taking medication with breastfeeding?
We advise
- Doctors and physicians
- patients
- midwives
- pharmacies
- Pharmaceutical industry
- Employees of the pregnancy counselling service
You will receive a feedback form from us to record any damage to the newborn following exposure during pregnancy. Please use it to inform us about the course and outcome of the pregnancy and early childhood development. Please use this opportunity - this is the only way to broaden the database and improve the quality of future information! We currently achieve a response rate of over 70 per cent.
You can download a form to release the doctors in charge from their duty of confidentiality here here.
Please send the completed form to the fax number: 0731 500-58656.
As we are not able to bill health insurance companies for our counselling services, we are dependent on grants and donations. To enable us to continue our work in the future, we would ask you to make a voluntary donation of 30 euros per consultation.
Find out more about this topic under Donations.
With our work in the advice centre for medication during pregnancy and breastfeeding, we want to develop perspectives for life.
We pursue this goal by
- advising on questions about medication, vaccines, infections, radiation and chemical exposure during pregnancy and breastfeeding.
- Preventing abortions by providing scientifically sound information.
- Tracking and documenting exposures during pregnancy. This enables us to better assess the reproductive toxicological risk.
- Offer further education and training for professionals and educate interested laypersons.
The pharmaceutical industry is retreating to a legally safe position by noting "contraindicated" or at least "strict indication" under the heading "pregnancy" in the product information for most preparations.
However, not treating chronically ill pregnant women with epilepsy, high blood pressure or bronchial asthma, for example, can lead to a dramatic worsening of the underlying disease - and thus to a considerable risk to the unborn child. On the other hand, inadequate information repeatedly leads to unnecessary abortions following exposure to medication, radiation, infections, workplace or environmental chemicals. This can be prevented with competent counselling.
Reproductive toxicology is concerned with the effects of potentially harmful factors on the fertility of the parents and the development of the child during pregnancy and breastfeeding. Such harmful factors include, for example, drugs, workplace and environmental chemicals. With the help of a database system and a communication network, we collect and analyse detailed information on the consequences of exposure to drugs or harmful substances. This enables us to quickly pass on the latest information on risk medications and harmful environmental factors.
When a drug is authorised, knowledge about its safety is naturally not complete. Until then, the drug has been tested on a comparatively small number of patients. Clinical trials with pregnant women in particular are almost impossible to conduct for ethical reasons. Even long after they have been authorised, new findings on the safety of medicinal products continue to emerge. It is therefore necessary to systematically monitor the safety of a finished medicinal product from the time of its marketing authorisation. This systematic monitoring is called pharmacovigilance.
We have been carrying out pharmacovigilance in the field of reproductive toxicology for over 25 years. This means that we monitor drug risks during pregnancy and breastfeeding. The growing number of consultations is an ideal basis for scientific evaluation. In recent years, we have been able to archive the course and outcome of more than 30,000 pregnancies in our FETIS database. For many substances, this makes it possible to draw conclusions about the risk of miscarriage and malformation after use in early pregnancy.
Between 1958 and 1961, around 10,000 children were born with severe limb defects whose mothers had taken the sleeping pill thalidomide. This became known nationwide as the thalidomide scandal. Since this catastrophe, the pharmaceutical industry, doctors and patients have rightly been cautious about the use of drugs.
According to statistical surveys, 15 to 50 per cent of all pregnant women take medication in the first trimester of pregnancy, often still unaware of their pregnancy. In view of the sensitive phase of organ formation in the first three months of pregnancy, this can have particularly fatal consequences.
After thalidomide (thalidomide), other fertility-damaging drugs such as vitamin A acid derivatives (e.g. isotretinoin), folic acid antagonists (e.g. methotrexate) or antiepileptic drugs (e.g. valproic acid) were discovered. The immunosuppressant mycophenolate mofetil has also recently been held responsible for malformations. A large number of other active substances are considered to be potentially damaging to fertility, whereby the effect of these drugs depends primarily on the dose and exposure time. There are case reports of malformations with numerous preparations, but studies with statistical significance are lacking.
Scientific evaluation of the data
In view of the increasing use of our counselling centre, there was a growing need to scientifically evaluate the resulting data in addition to the counselling function. As embryotoxicological research is usually limited to animal experiments for ethical reasons, this provided an ideal opportunity to improve the often very poor data situation in humans by carefully collecting data on enquiries about the use of medication in early human pregnancy. Thanks to the dedicated cooperation of enquirers, it has now been possible to increase the response rate to over 70 per cent.
In recent years, we have been able to archive the course and outcome of over 30,000 pregnancies in our FETIS database. For many substances, this makes it possible to draw conclusions about the risk of miscarriage and malformation after use in early pregnancy. Counselling and scientific recording must be inextricably linked in this sensitive area. This is the only way we can continue to provide effective help to affected parents in the future.
Our service is free of charge, but donations are welcome. You can support our work! Unfortunately, our medical counselling cannot yet be reimbursed by health insurance companies. The counselling centre, which has received significant support from the Diocese of Rottenburg-Stuttgart since 2002, is therefore also dependent on grants and donations. For this reason, we ask you to make a voluntary donation of 30 euros per consultation. Of course you can set the amount yourself. Our suggestion is for guidance only.
Your donation will help us:
- We can offer concrete help for expectant or breastfeeding mothers through our counselling centre.
- We can advance our research into the assessment of miscarriage and malformation risks.
- Unnecessary abortions can be avoided.
Via the donation platform betterplace.org:
Directly via our bank account:
Ulm University Hospital
IBAN: DE166305 0000 0000 1064 78
BIC: SOLADES1ULM
Purpose: S.173 Reprotox
For donations up to 200 euros, the receipt or bank statement stamped by your bank will be recognised by the tax office. If you would like a donation receipt, please state your full address on the remittance slip.
In order to achieve our goals, our advice centre cooperates with the following institutions.
In 1990, a European network of cooperating embryotoxicological advice centres was formed under the name ENTIS (European Network of Teratology Information Services). More than 30 centres from all over Europe now work together in this network. Our advice centre has been participating in ENTIS as a German reference centre together with the "Berlin Advice Centre for Embryotoxicology" since 1992. In cooperation with the ENTIS group, we have been developing an international follow-up programme (FETIS) since 1992. We use this programme to document and evaluate the enquiries received.
Our advice centre has been a member of the "Arbeitsgemeinschaft Arzneimitteltherapie bei psychiatrischen Erkrankungen" (AGATE) since 1999. The Bavarian district hospitals have joined forces in AGATE to ensure and optimise quality in the use of medication. AGATE emerged from the "Arzneimittelüberwachung in der Psychiatrie Bayerns" (AMÜP-Bayern) in 2000. Between 1979 and 1989, AMÜP-Bayern developed the methods for establishing a specialised pharmacovigilance system. This system focusses on psychopharmacology as a branch of clinical pharmacology.
Our institution serves AGATE as a contact point for counselling and data collection on the use of psychotropic drugs during pregnancy and breastfeeding.
We owe the continued existence of our counselling centre primarily to the Diocese of Rottenburg-Stuttgart, which has borne the main burden of funding since 2002.
Bishop Dr Gebhard Fürst describes the support of REPROTOX by the Diocese of Rottenburg-Stuttgart as follows: "Despite its tight budget situation, the Diocese of Rottenburg-Stuttgart has decided in favour of the people- and life-friendly research centre out of full and deepest conviction. The diocese is making an exemplary and forward-looking contribution to how the movement to stand up for life can look in concrete terms. Abortions can be avoided by providing information about possible damage during pregnancy or treatment suggestions for illnesses during pregnancy and breastfeeding."
Founded in 1967, the University of Ulm has formed the scientific basis for our activities for decades. Here, co-operation and interdisciplinarity are guaranteed by the close proximity of all disciplines under one roof.
The origin of our collaboration was a commission from the German Society of Gynaecology and Obstetrics (DGGG) in 1976: The University Women's Hospital Ulm was to set up a counselling hotline for medication during pregnancy and breastfeeding.
Since 1 April 2017, our advice centre has once again been located directly at the Ulm University Women's Hospital, where we have an ideal scientific infrastructure at our disposal.
From 2002 to 2017, our institute was based at St Elisabeth Hospital in Ravensburg, an academic teaching hospital of the University of Ulm. The hospital is part of the Oberschwabenklinik GmbH network.
The St. Elisabeth Foundation, based in Bad Waldsee, managed our facility on behalf of the Diocese of Rottenburg-Stuttgart at St. Elisabeth Hospital in Ravensburg from 2002 to 2017. The foundation operates social facilities and services in Baden-Württemberg - mainly between Ulm and Lake Constance.
The KVBW refers people to our advice centre, particularly if they have questions about possible harm to the child due to the use of medication in ignorance of an existing pregnancy. Since 2014, our project has been supported by an annual grant from the KVBW.
Dr Wolfgang Paulus has been an associate member of the Drug Commission of the German Medical Association (AkdÄ) since 2006. This institution deals with issues of drug safety in Germany.