Botox passes pregnancy tests
Research suggests the toxin shouldn’t seep from facial muscles or pose a threat, reports SHARON KIRKEY.
The growing number of women postponing motherhood until they’re older is posing a new dilemma for doctors: Is Botox safe in pregnancy? Writing in this month’s issue of the journal Canadian Family Physician, doctors with the Motherisk program at Toronto’s Hospital for Sick Children say that, with a proper injection, Botox shouldn’t seep from the facial muscles into a woman’s circulation.
As well, small studies involving women who were exposed to botulism poisoning in their second and third trimester of pregnancy found no evidence of birth defects in their babies, suggesting the toxin, even when it reaches the bloodstream, doesn’t appear to cross the placenta.
“With more women delaying pregnancy until later in life, inadvertent exposure of pregnant women to (Botox) is likely to occur at a greater frequency,” the authors write.
DR. GIDEON KOREN ‘The numbers aren’t large enough for me to be able to tell you that it’s 100-per-cent safe.’
Dr. Gideon Koren, director of Motherisk and one of the authors, said more women use Botox “for obvious reasons.” The drug temporarily paralyzes facial muscles, diminishing wrinkles. It is also used for migraine and tension headaches, as well as muscle and neck spasms.
“Very young women in their 20s are not likely to do Botox,” Koren said. “But now many, many pregnancies occur at 30, 35, 40, even 45. So the occurrence of a pregnancy with Botox may not be rare.”
As well, half of all pregnancies aren’t planned, Koren said.
“So, here’s a woman who did not know that she’s pregnant, she’s doing Botox and then she finds out she’s pregnant.”
According to the authors, the botulinum toxin is a large protein with a high molecular weight. Drugs and chemicals above a certain size and weight are less likely to cross the placenta.
In one study involving 28 women who used Botox when they were pregnant (at least 18 of the 28 during their first trimester), there were 25 normal, live pregnancies, one abortion and two miscarriages. However, both women who miscarried had a history of miscarriages.
“These are small numbers,” Koren said. “But if it would have caused malformations you would have expected to see one or two or three malformed kids.”
He said the data should come as a reassurance to women who were exposed to Botox before they knew they were pregnant, or for the rare cases of botulism poisoning.
In one study involving 28 women who used Botox when they were pregnant (at least 18 of the 28 during their first trimester), there were 25 normal, live pregnancies.
“The numbers aren’t large enough for me to be able to tell you that it’s 100-per-cent safe,” he said. “But if you happen to have been exposed, don’t take extreme measures such as terminating your pregnancy.” He said some women who are exposed to chemicals or drugs in their first trimester before knowing they were pregnant, “are ready to terminate because someone scared them.”
He said no one is suggesting that pregnant women start using Botox. Until more data is available, “the benefits and potential risks to both the mother and the infant should be considered when recommending (botulinum toxin type A, or Botox) injection to a pregnant patient,” Koren and his co-authors write.
“If a woman calls me or another doctor and asks, ‘Can I do it during pregnancy? My sister is getting married …’ Probably you should not,” Koren said.