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Tretinoin is widely used as a topical therapy for acne and photo-aging. Since tretinoin is an all-trans isomer of 13-cis-retinoic acid (Accutane), it is contraindicated in pregnant women. Tretinoin is teratogenic in animals when given orally, but there is no evidence of teratogenicity in the 291 human pregnancy outcomes that have been published.
This study prospectively evaluated pregnant women who had contacted an advisory clinic about tretinoin use during the first trimester and a matched group of control women who consulted the clinic for use of other drugs known not to be teratogenic.
Between 1988 and 1996, 94 cases of tretinoin exposure were identified. These pregnancies resulted in 86 live births (including one set of twins), 6 miscarri…