Embryo Project Encyclopedia

Isotretinoin is a molecule and a byproduct (metabolite) of vitamin A, and in greater than normal amounts in pregnant women, it can cause fetal abnormalities including cleft lips, ear and eye defects, and mental retardation. Isotretinoin is commonly called by its trade name Accutane, and it's a chemical compound derived from vitamin A, or retinoic acid. Doctors prescribe isotretinoin to treat severe acne. For pregnant women, too much vitamin A or isotretinoin can also cause greater than normal rates of stillbirths and fetal disintegrations after the ninth week of gestation. Women who use isotretinoin during the first trimester of their pregnancies, even in small amounts, risk defects to their fetuses such as external ear malformations, cleft palates, undersized jaws (micrognathia), a variety of heart defects, buildups of fluids inside the skulls that leads to brain swelling (hydrocephalus), small heads and brains (microcephaly), and mental retardation.

Josef Warkany studied the environmental causes of birth defects in the United States in the twentieth century. Warkany was one of the first researchers to show that factors in the environment could cause birth defects, and he helped to develop guidelines for the field of teratology, the study of birth defects. Prior to Warkany’s work, scientists struggled to explain if or how environmental agents could cause birth defects. Warkany demonstrated that a deficiency or excess of vitamin A in maternal nutrition could cause birth defects. He also established that mercury in teething powders increased infant mortality rates. Warkany showed how substances outside the human body could adversely affect conception, growth, and development of the human fetus in utero.

In the 2014 case Burwell v. Hobby Lobby, the US Supreme Court ruled that the contraceptive mandate promulgated under the Patient Protection and Affordable Care Act violated privately held, for-profit corporations’ right to religious freedom. The contraception mandate, issued in 2012 by the US Department of Health and Human Services, required that employer-provided health insurance plans offer their beneficiaries certain contraceptive methods free of charge. In a five to four decision, the US Supreme Court maintained that the mandate, in cases of privately held, for-profit organizations like Hobby Lobby Inc., violated the Religious Freedom Restoration Act of 1993. Although the Court did not decide on the constitutionality of the mandate, their ruling enabled privately held, for-profit corporations that objected to the contraceptive mandate on religious grounds to be exempt from it.

The article Experimental Studies on Congenital Malformations was published in the Journal of Chronic Diseases in 1959. The author, James G. Wilson, studied embryos and birth defects at the University of Florida Medical School in Gainesville, Florida. In his article, Wilson reviewed experiments on birds and mammals from the previous forty years to provide general principles and guidelines in the study of birth defects and teratogens, which are things that cause birth defects. Those principles included what species are convenient for conducting teratological research, what principles act in human embryological and fetal development, and what agents impact those processes. Wilson's article was one of the first attempts in the twentieth century to synthesize basic research conducted in the field of teratology. The article helped to establish teratology as a field in medicine during the twentieth century.

Sidney Q. Cohlan studied birth defects in the US during the twentieth century. Cohlan helped to discover that if a pregnant woman ate too much vitamin A her fetus faced a higher than normal risk of teratogenic effects, such as cleft palate. A teratogen is a substance that causes malformation of a developing organism. Cohlan also identified the teratogenic effects of several other substances including a lack of normal magnesium and prenatal exposure to the antibiotic tetracycline. Cohlan's experiments with vitamins and other chemicals brought attention to how nutrition and environmental agents adversely affect human pregnancy outcomes.

Dorothy Andersen studied cystic fibrosis in the United States during the early 1900s. In 1935, Andersen discovered lesions in the pancreas of an infant during an autopsy, which led her to classify a condition she named cystic fibrosis of the pancreas. In 1938, Andersen became the first to thoroughly describe symptoms of the medical condition cystic fibrosis. Commonly mistaken for celiac disease prior to the 1900s, Andersen defined cystic fibrosis as the build-up of pancreatic fluid in the body caused by the blockage of pancreatic ducts, and she determined that the two conditions were symptomatically different. Andersen developed an early method for
diagnosing cystic fibrosis. By conceptualizing cystic fibrosis and
defining its symptoms, Andersen laid the foundation for treatments that
enabled infants diagnosed with the disease to survive into adulthood.

Better babies contests were competitions held in state fairs throughout the US during the early twentieth century in which babies between the ages of 6 and 48 months were judged for their health. In 1908, social activist Mary de Garmo established and held the first better babies contest at the Louisiana State Fair in Shreveport, Louisiana. The contests, mirroring theories established in the US’s eugenics movement of the twentieth century, aimed to establish standards for judging infant health. Nurses and physicians judged infants participating in the contest on mental health, physical health, and physical appearance. In 1913, the Woman’s Home Companion (WHC) magazine cosponsored de Garmo’s better babies contests and introduced the competition to state fairs throughout the US. Better babies contests helped promote routine health assessments of children by medical professionals.

Better babies contests were competitions held in state fairs throughout the US during the early twentieth century in which babies between the ages of 6 and 48 months were judged for their health. In 1908, social activist Mary de Garmo established and held the first better babies contest at the Louisiana State Fair in Shreveport, Louisiana. The contests, mirroring theories established in the US’s eugenics movement of the twentieth century, aimed to establish standards for judging infant health. Nurses and physicians judged infants participating in the contest on mental health, physical health, and physical appearance. In 1913, the Woman’s Home Companion (WHC) magazine cosponsored de Garmo’s better babies contests and introduced the competition to state fairs throughout the US. Better babies contests helped promote routine health assessments of children by medical professionals.

On 30 June 1980, in a five to four decision, the US Supreme Court ruled in the Case Harris v. McRae that the Hyde Amendment of 1976 did not violate the US Constitution. The Hyde Amendment banned the use of federal funding to pay for any abortion services. The US Supreme Court's decision in Harris v. McRae overturned the decision of McRae v. Califano (1980), in which the US District Court for the Eastern District of New York had ruled that the funding restrictions established by the Hyde Amendment violated the US Constitution. After the US Supreme Court's ruling in Harris v. McRae, the Hyde Amendment continued to prohibit federal Medicaid funding for abortion services, limiting the funds available for low-income women seeking abortions.

Thalidomide is a sedative drug introduced to European markets on 1 October 1957 after extensive testing on rodent embryos to ensure its safety. Early laboratory tests in rodent populations showed that pregnant rodents could safely use it, so doctors prescribed Thalidomide to treat morning sickness in pregnant women. However, in humans Thalidomide interfered with embryonic and fetal development in ways not observed in rodent tests. Pregnant women who take Thalidomide are at grater than normal risk for spontaneous abortion and for giving birth to children with developmental anomalies such as shortened, absent, or extra limbs, as well as a variety of heart, ear, and internal organ defects. The failure of rodent models to inform scientists of Thalidomide's teratogenicity in humans ignited debate about the proper use of cross-species testing during drug development.