Pharmacology and toxicology
Mosquito repellents, such as diethyltoluamide (DEET), are rubbed into or sprayed on the skin. Absorption through the skin is about
8-17% (Sudakin 2003). A mother in Africa who gave birth to a mentally retarded child had not only been using malarial prophylaxis (chloroquine), but also rubbing her arms and legs daily with a 25% DEET lotion (Schaefer 1992). Since DEET has neurotoxic properties and is absorbed through the skin, the authors cannot entirely eliminate a causal connection. However, there are no further reports on toxic effects oil prenatal development.
A randomized prospective study covering 449 pregnant women with an average topical application of 1.7g daily of DEET during the second and third trimesters could not demonstrate any difference in the newborn and the development of the infants up to the age of 1 year compared to the control group. However, DEET was found in 8% of the cord blood specimens (McGready 2001).
There is insufficient documented experience on DEET during the first trimester.
Icaridin is less toxic in general than DEET. There arc no studies on its use during pregnancy.
Recommendation. Pregnant women should be advised against using insect repellents of the DEET type on large areas of their bodies for a long time unless there is a strong indication. In areas where the risk of malaria is high (which should only be visited during pregnancy when there are compelling grounds to do so), the risk for both mother and child associated with the use of DEET is still clearly less than the risk of a malarial infection. However, apart from non-chemical protection (covering the skin, etc.), less toxic repellents (including icaridin) should be chosen. The use of DEET in the first trimester justifies neither an interruption of the pregnancy nor invasive diagnostic procedures.
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