{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T21:05:21Z","timestamp":1793480721947,"version":"4.5.0"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and\/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A retrospective review was conducted examining visits in 2008\u20132012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic medical records were queried for demographic information, evidence of contraceptive provision, and menstrual and sexual histories. The data were analyzed using standard statistical methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Within 4172 clinic visits, 1694 females received 4506 prescriptions for teratogenic medications. The most commonly prescribed teratogens were topiramate, methotrexate, diazepam, isotretinoin, and enalapril. The subspecialties prescribing teratogens most frequently were neurology, hematology-oncology, and dermatology. Overall, contraceptive provision was documented in 28.6% of the visits. Whites versus nonwhites and older versus younger girls were more likely to receive contraceptive provision. The presence of a federal risk mitigation system for the teratogen also increased the likelihood of contraceptive provision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Our data demonstrate female adolescents prescribed teratogens receive inadequate contraception provision, which could increase their risk for negative pregnancy outcomes. Although the presence of a federal risk mitigation system appears to improve contraceptive provision, these systems are costly and, in some instances, difficult to implement. Efforts to improve provider practices are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2015-1454","type":"journal-article","created":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T02:41:07Z","timestamp":1450320067000},"source":"Crossref","is-referenced-by-count":44,"title":["Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications"],"prefix":"10.1542","volume":"137","author":[{"given":"Stephani L.","family":"Stancil","sequence":"first","affiliation":[{"name":"Divisions of Adolescent Medicine,"},{"name":"Division of Pharmacology and Toxicology, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Miller","sequence":"additional","affiliation":[{"name":"Emergency Medicine, and"},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holley","family":"Briggs","sequence":"additional","affiliation":[{"name":"Kansas City University of Medicine and Biosciences, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl","family":"Lynch","sequence":"additional","affiliation":[{"name":"Divisions of Adolescent Medicine,"},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Goggin","sequence":"additional","affiliation":[{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;"},{"name":"Health Services and Outcomes Research, Children\u2019s Mercy Hospital, Kansas City, Missouri;"},{"name":"University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kearns","sequence":"additional","affiliation":[{"name":"Division of Pharmacology and Toxicology, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri;"},{"name":"Arkansas Children\u2019s Hospital Research Institute, Little Rock, Arkansas; and"},{"name":"Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2016,1,1]]},"reference":[{"issue":"6","key":"2021120907211280500_B1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.7326\/0003-4819-147-6-200709180-00006","article-title":"Documentation of contraception and pregnancy when prescribing potentially teratogenic medications for reproductive-age women.","volume":"147","author":"Schwarz","year":"2007","journal-title":"Ann Intern Med"},{"issue":"11","key":"2021120907211280500_B2","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.amjmed.2005.02.029","article-title":"Prescription of teratogenic medications in United States ambulatory practices.","volume":"118","author":"Schwarz","year":"2005","journal-title":"Am J Med"},{"issue":"4","key":"2021120907211280500_B3","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2217\/WHE.12.25","article-title":"Balancing act: safe and evidence-based prescribing for women of reproductive age.","volume":"8","author":"Pace","year":"2012","journal-title":"Womens Health (Lond Engl)"},{"issue":"4","key":"2021120907211280500_B4","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.contraception.2011.01.024","article-title":"Opportunities missed: improving the rate of contraceptive counseling or provision when prescribing reproductive-aged women potentially teratogenic medications in a family medicine resident clinic.","volume":"84","author":"Fritsche","year":"2011","journal-title":"Contraception"},{"issue":"1","key":"2021120907211280500_B5","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.reprotox.2008.06.003","article-title":"Paternal exposure and counselling: experience of a Teratology Information Service.","volume":"26","author":"De Santis","year":"2008","journal-title":"Reprod Toxicol"},{"issue":"3","key":"2021120907211280500_B6","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/j.1365-2133.2005.07083.x","article-title":"Thalidomide, semen distribution, teratogenicity ... and cost.","volume":"154","author":"Laffitte","year":"2006","journal-title":"Br J Dermatol"},{"key":"2021120907211280500_B7","unstructured":"United States Food and Drug Administration\n          . 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