Clinical Pharmacology

MOTHERISK PROGRAM

Director	Contact
Gideon Koren	Hospital for Sick Children 555 University Avenue Toronto, Ontario M5G 1X8

Brief Description

Motherisk (www.motherisk.org) is a multi-disciplinary program, based at The Hospital for Sick Children, that combines clinical counseling and research activities in the area of reproductive toxicology, breastfeeding pharmacology, and drugs of abuse, including alcohol. The program receives nearly 40,000 inquiries per year about fetal toxicity of maternal exposures to medications and other potentially teratogenic agents.  Research projects range from effects of maternal antidepressants on cognitive function of the offspring, to the molecular mechanisms of drug transport in the placenta and mammary gland. Faculty members from several departments including pediatrics, medicine, psychiatry, and obstetrics and gynecology participate in the research.

Principal Investigators

Name	Department	Major Research Interest
Gideon Koren	Pediatrics	Reproductive toxicology, pharmacology
Shinya Ito	Pediatrics	Breastfeeding, pharmacology
Wee Shian Chan	Medicine	Obstetric medicine
Dafna Gladman	Medicine	Rheumatology
Carl Laskin	Medicine	Rheumatology
Shital Ghandi	Medicine	Obstetric Medicine
Joanne Rovet	Psychology	Cognitive function development
Dan Farine	Obstetrics	Fetal medicine

Recent Original Research Publications 

Magee LA, Schick B, Donnenfeld AE, Sage SR, Conover B, Cook L, McElhatton PR, Schmidt MA, Koren G. The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study. Am J Obstet Gynecol 174:823-8, 1996.

Nulman I, Rovet J, Stewart D, Wolpin J, Gardner HA, Theis JGW, Kulin N, Koren G.  Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 336:258-262, 1997.

Pastuszak A, Schuler L, Speck-Martins CE, Coelho KEFA, Vargas FR, Brunoni D, Schwarz IVD, Larrandaburu M, Safattle H, Lordello SM, Melon VFA, Koren G. Use of misoprostol during pregnancy and Mobius sequence in infants. N Engl J Med 338:1881-1885, 1998.

Kulin N, Pastuszak AP, Sag SR, Schick B, Spivey G, Feldkamp M, Ormond K, Matsui D, Stein-schechman AK, Cook L, Brochu J, Rieder M, Koren G. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors. A prospective controlled multicenter study. JAMA 279:609-610, 1998.

Klinger G, Morad Y, Westall CA, Laskin C, Spitzer KA, Koren G, Ito S, Buncic RJ. Ocular toxicity and antenatal exposure to chloroquine or hydroxychloroquine for rheumatic diseases. Lancet 358:813-4, 2001.

Future Directions

We will continue focusing on safety of maternal drugs during pregnancy and lactation. Specific future directions include fetal alcohol syndrome research, behavioral teratology of various psycoactive medications, and laboratory investigations to identify biological markers of alcohol and other drug of abuse exposure in utero.