Isotretinoin (13-cis-retinoic acid, Accutane) increases the risk of major 
congenital malformations in infants exposed to isotretinoin during pregnancy. 
However, there have been no epidemiologic reports to date on the effect of a 
subsequent pregnancy after discontinuation of isotretinoin. This article 
describes our analysis of pregnancy case reports from patients in whom 
conception occurred after isotretinoin treatment had been discontinued. Based on 
the 88 prospectively ascertained cases, the incidence rate of both spontaneous 
and missed abortions from all pregnancies was 9.1% (eight patients), and the 
incidence rate of congenital malformation among the live births was 5.0% (four 
patients). The incidence rates for both these outcomes were not significantly 
different from the rates reported for women of reproductive age in the general 
population. In addition, the malformations reported were not characteristic of 
retinoic acid-induced congenital anomalies.