#406 Mock Teratogen Genetic Counseling Session: Ozempic, Zoloft, Xanax, and Metformin

This is our seventh installment in our Mock Genetic Counseling Session Series! In this episode, genetic counselor and teratogen information specialist Sharon Voyer Lavigne and student Edith Atwerebour perform a mock genetic counseling session. The session indication is medication exposures during pregnancy, including Ozempic®, metformin, Zoloft®, and Xanax®.

This session was recorded in person, providing a more dynamic and engaging learning experience. Therefore, we highly recommend watching it on YouTube to fully immerse yourself in the interaction.

We hope this series is helpful for prospective and current genetic counseling students, as well as the general public, by demystifying the genetic counseling process.

The Actors:

Edith Atwerebour is currently a student in the Human Genetics Program at Sarah Lawrence College training to become a genetic counselor. In this mock session, she plays Denise, a 34-year-old woman who is pregnant with her second child and seeking information about medication exposures during pregnancy. The premise of this mock case was developed as part of Atwerebour’s internship with DNA Today.

Sharon Voyer Lavigne, MS, LGC, is a licensed genetic counselor, teratogen information specialist, and Coordinator of MotherToBaby Connecticut. She has worked with MotherToBaby Connecticut for more than 28 years and also serves as its Research Coordinator. Lavigne is a Clinical Instructor in the Division of Human Genetics within the Department of Genetics and Genome Sciences at UConn Health. She teaches and trains genetic counseling students, maternal-fetal medicine fellows, OB/GYN residents, and other healthcare professionals.

Lavigne received her Bachelor of Science in Biology from Northeastern University and her Master of Science in Human Genetics/Genetic Counseling from Sarah Lawrence College. Through MotherToBaby, she helps patients and healthcare professionals understand the most current evidence about medications and other exposures during pregnancy and breastfeeding.

Mock Session Overview:

• How genetic counselors establish the approximately 3% background risk for birth defects before discussing specific exposures
• Why the timing, dose, frequency, and duration of a medication exposure matter
• What is currently known, and still unknown, about semaglutide (Ozempic®/Wegovy®) exposure during early pregnancy
• Why controlling type 2 diabetes may be more important than the medication exposure itself
• The role of metformin, insulin, maternal-fetal medicine specialists, and diabetes educators during pregnancy
• What research suggests about sertraline (Zoloft®) use and the risk for structural birth defects
• How untreated anxiety and depression can also affect maternal and pregnancy health
• Possible newborn adaptation symptoms following exposure to certain psychiatric medications
• Why patients should consult their healthcare providers before reducing or discontinuing medication
• How therapy, family support, and postpartum planning can complement medication management
• The role of anatomy ultrasounds and fetal echocardiograms in pregnancy monitoring
• How MotherToBaby helps patients and healthcare providers navigate exposures during pregnancy and breastfeeding

The central takeaway from the session is that Denise’s reported medication exposures are not expected to place the pregnancy at a significantly greater overall risk. Instead, the primary priorities are improving diabetes control, maintaining her mental health, and coordinating care among her obstetrician and other healthcare providers.

MotherToBaby Resources:

MotherToBaby provides free, evidence-based information about medications and other exposures during pregnancy and breastfeeding. Patients and healthcare providers can contact MotherToBaby by phone, text, email, or live chat.

MotherToBaby Pregnancy and Breastfeeding Fact Sheets

MotherToBaby: Semaglutide (GLP-1s like Ozempic®, Wegovy®, Rybelsus®)

MotherToBaby: Metformin (Glucophage®, Glumetza® and Fortamet®)

MotherToBaby: Sertraline (Zoloft®)

MotherToBaby: Alprazolam (Xanax®, Niravam®, Gabazolamine-0.5®)

Previous Installments of Our Mock Genetic Counseling Session Series:

Episode #311: Cancer Session for Breast and Prostate Cancer Family History

Episode #317: Prenatal Session for Advanced Maternal Age

Episode #331: Pediatric Session for Autism

Episode #351: Cardio Session for Sudden Death of a Family Member

Episode #368: Prenatal Session for Increased Nuchal Translucency

Episode #373: Pediatric Session for an Abnormal Cystic Fibrosis Newborn Screening Result

Disclaimer:

Please note that the information provided in this mock genetic counseling session is intended strictly for educational purposes and should not be used for personal medical decision-making. Medication risks and benefits during pregnancy vary based on the individual, medication, dose, timing, and underlying medical condition.

If you have questions or concerns about your health, we encourage you to consult directly with a certified genetic counselor or another qualified healthcare provider who can provide individualized medical recommendations. If you are in the United States, you can find a genetic counselor near you by visiting FindAGeneticCounselor.com.

Connect with DNA Today:

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DNA Today is hosted and executive produced by Kira Dineen, MS, LCGC, CG(ASCP)CM. Liv Davidson is our Social Media Lead and Eric Knaus is our Digital Marketing and Automation Lead.