Abstract
Some practitioners may remember the days when it was believed that the fetus was protected from harmful environmental influences by the placenta; today, no physician can be unaware that drugs or other agents can and do cause birth defects. In fact, this year marks the 50th anniversary of the first identification of a human teratogen—in 1941, Gregg 1 published his landmark observation that maternal rubella infection in the first trimester of pregnancy was associated with a characteristic pattern of birth defects. It took two more decades until it was recognized that a medication ingested in early pregnancy could also produce birth defects. Discovery of the teratogenicity of thalidomide in 1961 2,3 came as a major surprise to the medical community, and the dramatic nature of the limb defects and the thousands of affected infants also shaped public perceptions and anxieties about exposure to environmental agents in pregnancy. What have we
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