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Kenneth Lyons Jones Christina D Chambers Department of Pediatrics

Adverse Reproductive Outcomes Surveillance and Outreach at the Border: California Teratogen Information Service and the San Diego Birth Defects Surveillance Program. Kenneth Lyons Jones Christina D Chambers Department of Pediatrics Division of Teratology/Dysmorphology

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Kenneth Lyons Jones Christina D Chambers Department of Pediatrics

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  1. Adverse Reproductive Outcomes Surveillance and Outreach at the Border: California Teratogen Information Service and the San Diego Birth Defects Surveillance Program Kenneth Lyons Jones Christina D Chambers Department of Pediatrics Division of Teratology/Dysmorphology University of California, San Diego, School of Medicine La Jolla, California

  2. California Teratogen Information Service: Goals • To provide a service to pregnant women and their physicians throughout California regarding the effects of various agents on fetal development. • To gain new information about the potential teratogenicity of drugs, chemicals, and environmental agents

  3. Hispanic Women Registered (%) • 1998 - 7.5% (>40% of births in CA to Mexican-American women) • 1999 – 11% (hired first Spanish speaking counselor) • 2000 – 18% • 2002 – 26% (received grant to develop strategies for providing information to pregnant women regarding exposures during pregnancy) • 2004 – 26%

  4. Future Directions Establish face-to-face, hospital-based teratogen counseling as part of the existing health system that is provided to pregnant women in Tijuana Establishment of telephone-based Teratogen Information Service in Tijuana to provide service to women and their physicians throughout Baja Norte. Acquire fellowship funding to train a Mexican physician in Teratology/Dysmorphology who could then extend our research agenda on the Mexican side of the border.

  5. San Diego Birth Defects Surveillance Program • Part of Slone Epidemiology Center at Boston University. • 4 sites including Boston, Toronto, Philadelphia, and San Diego. • Case-control study involving all birthing hospitals in San Diego County. • Interviews of cases and controls occur in first 6 months of life and document over-the –counter as well as prescription medications

  6. Importance of Birth Defects Surveillance that includes Both Sides of the Border • Environmental factors that may affect the incidence of birth defects in San Diego may impact the incidence of birth defects in Tijuana and vice versa

  7. Examples • Congenital rubella • Differences in uptake of folic acid supplementation • Alcohol consumption by pregnant women – high in San Diego, but not in Tijuana? • Safety regulations re environmental pollution – more stringent in San Diego? • Availability of teratogenic drugs over-the-counter in Tijuana, e. g., Ro-accutane • Unknown environmental factors that may affect both sides of the border, e.g., air quality.

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