Which medication may cause teratogenic effects like skeletal and CNS defects?

Warfarin is an anticoagulant that is known to have teratogenic effects, particularly during the first trimester of pregnancy. It can cross the placenta and lead to a variety of congenital abnormalities, including skeletal defects such as nasal hypoplasia and limb deformities, as well as central nervous system (CNS) defects like brain malformations. The risk associated with warfarin is particularly significant, as it can impact fetal development in ways that may not be immediately apparent, leading to long-term complications.

For instance, warfarin can interfere with the normal process of bone development, resulting in specific skeletal anomalies commonly associated with its use during pregnancy. Additionally, because warfarin acts as a vitamin K antagonist, it can lead to issues with coagulation in the newborn, potentially leading to intracranial hemorrhage.

While the other medications listed—simvastatin, propranolol, and atenolol—also have implications for pregnancy, they do not carry the same level of risk for teratogenic effects specifically related to skeletal and CNS defects as warfarin does. Simvastatin belongs to the class of statins and is generally avoided during pregnancy due to potential risks to fetal development in other ways but is not as explicitly linked to