Possible Teratogenic Hyperthermia and Marathon Running

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Abstract
To the Editor.— The article by John D. Cantwell, MD (240:1409, 1978), extolled the many benefits of running. I would like to add a note of caution for women runners; namely, that marathon running may pose a teratogenic risk during early pregnancy. This warning seems warranted on the basis of the following evidence: First, marathon runners experience sustained increases of core temperature into the "high fever" range.1,2Second, recent studies3-5have shown an association between birth defects and episodes of maternal hyperthermia. Because the first half of gestation is apparently the period of greatest risk for hyperthermia-induced birth defects,4a substantial number of women may already have trained for and run the marathon during this critical period, either because they were unaware of or unhindered by their pregnancy. A study of the outcomes of such pregnancies might be informative in regard to the relationship between high maternal

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