ORGANIZATION OF ORGANIZATION OF TERATOLOGY INFORMATION TERATOLOGY INFORMATION

SPECIALISTSSPECIALISTS

Sharon Voyer Lavigne, MSSharon Voyer Lavigne, MSCoordinator, CT Pregnancy Exposure Coordinator, CT Pregnancy Exposure

Information ServiceInformation ServicePresident, OTISPresident, OTIS

North American Network of North American Network of Telephone ServicesTelephone Services

– Based in universities, hospitals and health Based in universities, hospitals and health departmentsdepartments

– 18 sites throughout U.S. and Canada18 sites throughout U.S. and Canada– Provide services to approximately 100,000 Provide services to approximately 100,000

women or health care providers each year women or health care providers each year – Pregnancy and breastfeeding exposuresPregnancy and breastfeeding exposures

Teratology Information Services Teratology Information Services (TIS(TIS))

Comprehensive multidisciplinary resources

Access to numerous specialists in:- teratology, dysmorphology, - toxicology, pharmacology, - epidemiology, infectious diseases,- clinical genetics, obstetric / maternal fetal medicine,- radiation biology, occupational and environmental

health

No cost services available to health-care providers and patients

Organization of Teratology Organization of Teratology Information SpecialistsInformation Specialists

Health care providers including:Health care providers including:– Genetic counselorsGenetic counselors– PhysiciansPhysicians– NursesNurses– Public health educatorsPublic health educators– PharmacistsPharmacists– Social workersSocial workers– Other specialtiesOther specialties

TIS’s ProvideTIS’s Provide

ServiceService – Toll-free phone consultation to – Toll-free phone consultation to patients or health care providers about patients or health care providers about exposures during pregnancyexposures during pregnancy

EducationEducation – to public and academic groups, – to public and academic groups, including medical, nursing, genetic counseling, including medical, nursing, genetic counseling, pharmacy and otherspharmacy and others

ResearchResearch – collaborative projects looking at – collaborative projects looking at outcomes of exposures to specific agentsoutcomes of exposures to specific agents

SERVICESERVICE

Telephone or in-person consultations that Telephone or in-person consultations that are free-of-charge and confidentialare free-of-charge and confidential

Current data and risk assessmentCurrent data and risk assessment

Information to help women make informed Information to help women make informed reproductive choicesreproductive choices

Who calls a TIS:Who calls a TIS:

CALLER PROFILE:CALLER PROFILE:

Patients Patients 47% 47%

Health Care Providers 46%Health Care Providers 46%

Relatives Relatives 4%4%

General Public General Public 2% 2%

Breastfeeding Mothers 1% Breastfeeding Mothers 1%

1%2% 4%

47% 46%

Common Exposures:Common Exposures:

MedicationsMedications 58%58%

Occupational AgentsOccupational Agents 17%17%

Environmental AgentsEnvironmental Agents 8% 8%

Drugs of AbuseDrugs of Abuse 6% 6%

Maternal IllnessMaternal Illness 4% 4%

Herbal ProductsHerbal Products 4% 4%

RadiationRadiation 3% 3%

58%

17%

8%

6%

4%4%3%

Reproductive Status:Reproductive Status:

PregnancyPregnancy 74%74%

PreconceptionPreconception9%9%

BreastfeedingBreastfeeding8%8%

Not specifiedNot specified 6%6%

Paternal questionPaternal question 3%3%

3% 6%

8%

9%

74%

Developing a Risk AssessmentDeveloping a Risk Assessment

Essential information:Essential information:– TimingTiming– DoseDose– Family, medical and pregnancy historyFamily, medical and pregnancy history– Other exposuresOther exposures

Literature ReviewLiterature Review

Databases – REPROTOX, TERIS, Databases – REPROTOX, TERIS, Reprotext, Shepard’s CatalogReprotext, Shepard’s Catalog

Books – Briggs, Gleicher, Shardein, HaleBooks – Briggs, Gleicher, Shardein, Hale

Drug Compendiums, PDR, PDR for HerbalsDrug Compendiums, PDR, PDR for Herbals

Journal articlesJournal articles

Providing a Risk AssessmentProviding a Risk Assessment

Collection of data on specific agentCollection of data on specific agent

Interpretation of data based on intake Interpretation of data based on intake informationinformation

Elicit callers’ knowledge and sourceElicit callers’ knowledge and source

Discuss 3-5% background riskDiscuss 3-5% background risk

Review risk vs. benefitReview risk vs. benefit

EDUCATIONEDUCATION

Public and health care provider workshops, Public and health care provider workshops, seminars or lecturesseminars or lectures

Student lectures (high school, college, etc)Student lectures (high school, college, etc)

Fact Sheets (Fact Sheets (http://www.otispregnancy.org/))

Professional educationProfessional education– Annual Education ConferenceAnnual Education Conference– OTIS/Teratology Society/NBTS Joint OTIS/Teratology Society/NBTS Joint

WorkshopsWorkshops

RESEARCHRESEARCH

Autoimmune Diseases in Pregnancy Autoimmune Diseases in Pregnancy

Discontinuation of Antidepressant Medication Discontinuation of Antidepressant Medication During PregnancyDuring Pregnancy

West Nile Virus and PregnancyWest Nile Virus and Pregnancy

Vaccinations in PregnancyVaccinations in Pregnancy

CDC Pilot ProjectCDC Pilot Project

Isotretinoin Pregnancy Prevention SurveyIsotretinoin Pregnancy Prevention Survey

OTIS and CDCOTIS and CDC

– Grant funding for annual OTIS Grant funding for annual OTIS educational conferenceeducational conference

– Hurricane Katrina ProjectHurricane Katrina Project– Pilot Project for a Pregnancy and Pilot Project for a Pregnancy and

Lactation Monitoring SystemLactation Monitoring System

www.otispregnancy.org

National Phone Number:(866) 626-OTIS(866) 626-6847