Objectives: This study aims at evaluating drug prescription patterns, the exposure to teratogenic drugs, the prevalence of chronic maternal diseases and the attitude towards the supplementation of folic acid in a selected high-risk population asking for a preconception counselling. Study Design: A descriptive study on 4077 cases of drug exposures carried out by an Italian Teratology Information Service, from January 2002 to October 2008. Results: The exposure to neurological drugs was the main reason for calling in women trying to get pregnant. Teratogenic drugs accounted for 40% of total prescriptions and chronic diseases, most of them neurological (70%), were highly prevalent (54%). Folic acid was dispensed to 54% of women at the time of call. In the subpopulation of women suffering from epilepsy, only 12% were given folic acid. Conclusions: The exposure to teratogenic drugs and the prevalence of chronic diseases is frequent in the population asking for a counselling and can increase the risk of a negative outcome of pregnancy. The prevalence of folic acid supplementation before conception is not yet sufficient and should be improved, especially in high- risk patients, such as epileptic women. The Teratology Information Service may support general health and provide information about preconception care thus improving the outcome of pregnancy, mainly in high-risk populations affected by chronic diseases and often treated by teratogenic drugs.