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Medication Use in Pregnancy; Treating the Mother: Protecting the Unborn

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Medicines For Women

Abstract

Each year, numerous new medications enter the market. The formal labeling for most of these drugs does not contain safety data related to exposure during gestation. However, millions of pregnant women have conditions that need to be treated such as diabetes, urinary tract infections and nausea and vomiting. The paucity of knowledge in regard to fetal safety of medications introduces significant challenges for practitioners, and situates the mother at risk of insufficient therapy for her disease, and her unborn baby at a potential risk of toxicity (McBride 1978; Koren 2013). For the vast majority of drugs which have been evaluated in pregnancy, large amount of data have failed to show fetal risks in humans (Koren et al. 1998). Most women are exposed to medications in pregnancy and although quite few medications have been shown to be teratogenic in humans, high levels of anxiety, coupled with misinformation and misperception, lead women and their prescribers to commonly avoid drug therapy even in life threatening conditions.

It is critical for clinicians to always consider the risks of the untreated conditions in pregnancy and as needed, to empower women to use medications during gestation. Presently, we must change the climate whereby pregnant women and their unborn babies become therapeutic orphans.

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References

  • Abel EL (1984) Pharmacology of alcohol relating to pregnancy and lactation. Plenum Press, Buffalo, pp 29–45

    Google Scholar 

  • Abstracts of digestive disease week and the 108th annual meeting of the American Gastroenterological Association Institute, 19–24 May 2007, Washington, DC. Gastroenterology. 2007;132(4 Suppl 2):A144

    Google Scholar 

  • Abstracts of the 72nd annual scientific meeting of the American College of Rheumatology and the 43rd annual scientific meeting of the Association of Rheumatology Health Professionals. 24–29 Oct 2008. San Francisco. Arthritis Rheum 2008; 58(Suppl 9):S161–S950

    Google Scholar 

  • Abstracts of the Teratology Society 52nd annual meeting, 23–27 June 2012, Baltimore. Birth Defects Res A Clin Mol Teratol. 2012;94(5):291–415

    Google Scholar 

  • ACOG committee opinion no. 475: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2011;117(2 Pt 1):422–424

    Google Scholar 

  • Adab N, Jacoby A, Smith D, Chadwick D (2001) Additional educational needs in children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry 70(1):15–21

    CAS  PubMed Central  PubMed  Google Scholar 

  • Adab N, Kini U, Vinten J, Ayres J, Baker G, Clayton-Smith J, Coyle H, Fryer A, Gorry J, Gregg J, Mawer G, Nicolaides P, Pickering L, Tunnicliffe L, Chadwick DW (2004) The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry 75(11):1575–1583

    CAS  PubMed Central  PubMed  Google Scholar 

  • Adams J, Lammer EJ (1993) Neurobehavioral teratology of isotretinoin. Reprod Toxicol 7(2):175–177

    CAS  PubMed  Google Scholar 

  • Al-Maawali A, Walfisch A, Koren G (2012) Taking angiotensin-converting enzyme inhibitors during pregnancy – is it safe? Can Fam Physician 58(1):49–51

    PubMed Central  PubMed  Google Scholar 

  • Alter BP (1985) Neonatal pancytopenia after maternal azathioprine therapy. J Pediatr 106(4):691

    CAS  PubMed  Google Scholar 

  • Alwan S, Polifka JE, Friedman JM (2005) Angiotensin II receptor antagonist treatment during pregnancy. Birth Defects Res A Clin Mol Teratol 73(2):123–130

    CAS  PubMed  Google Scholar 

  • Andrade SE, Gurwitz JH, Davis RL et al (2004) Prescription drug use in pregnancy. Am J Obstet Gynecol 191(2):398–407

    PubMed  Google Scholar 

  • Andrade SE, McPhillips H, Loren D, Raebel MA, Lane K, Livingston J, Boudreau DM, Smith DH, Davis RL, Willy ME, Platt R (2009) Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 18(3):246–252

    PubMed  Google Scholar 

  • Andresen M (2006) Accutane registry compulsory in US, but not Canada. CMAJ 174(12):1701

    PubMed Central  PubMed  Google Scholar 

  • Armenti VT, Radomski JS, Moritz MJ, Gaughan WJ, Philips LZ, McGrory CH, Coscia LA (2002) National Transplantation Pregnancy Registry. Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl 2002:121–130

    Google Scholar 

  • Artama M, Auvinen A, Raudaskoski T, Isojärvi I, Isojärvi J (2005) Antiepileptic drug use of women with epilepsy and congenital malformations in offspring. Neurology 64(11):1874–1878

    CAS  PubMed  Google Scholar 

  • Bald M, Holder M, Zieger M, Vochem M, Leichter HE (2005) Increased renal echogenicity in a preterm neonate. Kidneys with tubular dysplasia due to exposure to candesartan during pregnancy. Pediatr Nephrol 20(11):1664-5, 1664-8

    Google Scholar 

  • Banach R, Boskovic R, Einarson T, Koren G (2010) Long-term developmental outcome of children of women with epilepsy, unexposed or exposed prenatally to antiepileptic drugs: a meta-analysis of cohort studies. Drug Saf 33(1):73–79

    CAS  PubMed  Google Scholar 

  • Bar-Oz B, Nulman I, Koren G, Ito S (2000) Anticonvulsants and breast feeding: a critical review. Paediatr Drugs 2(2):113–126

    CAS  PubMed  Google Scholar 

  • Bar-Oz B, Einarson T, Einarson A et al (2007) Paroxetine and congenital malformations: metaanalysis and consideration of potential confounding factors. Clin Ther 29:918–926

    CAS  PubMed  Google Scholar 

  • Barr M Jr (1994) Teratogen update: angiotensin-converting enzyme inhibitors. Teratology 50(6):399–409

    CAS  PubMed  Google Scholar 

  • Bennett PN (1996) Drugs and human lactation, 2nd edn. Elsevier, Amsterdam

    Google Scholar 

  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103(4):698–709

    PubMed  Google Scholar 

  • Berle JO, Steen VM, Aamo TO et al (2004) Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome P450 genotypes. J Clin Psychiatry 65:1228–1234

    CAS  PubMed  Google Scholar 

  • Biswas PN, Wilton LV, Shakir SW (2002) The safety of valsartan: results of a postmarketing surveillance study on 12881 patients in England. J Hum Hypertens 16(11):795–803

    CAS  PubMed  Google Scholar 

  • Bloom SL, Sheffield JS, McIntire DD, Leveno KJ (2001) Antenatal dexamethasone and decreased birth weight. Obstet Gynecol 97:485–490

    CAS  PubMed  Google Scholar 

  • Bogen DL, Sit D, Genovese A, Wisner KL (2012) Three cases of lithium exposure and exclusive breastfeeding. Arch Womens Ment Health 15(1):69–72

    PubMed Central  PubMed  Google Scholar 

  • Bonari L, Pinto N, Ahn E et al (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49:726–734

    PubMed  Google Scholar 

  • Born D, Martinez EE, Almeida PA, Santos DV, Carvalho AC, Moron AF, Miyasaki CH, Moraes SD, Ambrose JA (1992) Pregnancy in patients with prosthetic heart valves: the effects of anticoagulation on mother, fetus, and neonate. Am Heart J 124(2):413–417

    CAS  PubMed  Google Scholar 

  • Boutroy MJ, Vert P, Hurault de Ligny B, Miton A (1984) Captopril administration in pregnancy impairs fetal angiotensin converting enzyme activity and neonatal adaptation. Lancet 2(8408):935–936

    CAS  PubMed  Google Scholar 

  • Brent RL (1986) The effects of embryonic and fetal exposure to x-ray, microwaves, and ultrasound. Clin Perinatol 13:615

    CAS  PubMed  Google Scholar 

  • Briggs GG, Nageotte MP (2001) Fatal fetal outcome with the combined use of valsartan and atenolol. Ann Pharmacother 35(7–8):859–861

    CAS  PubMed  Google Scholar 

  • Briggs GG, Freeman RK, Yaffe SL (2008) Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk, 8th edn. Wolters Kluwer Health/Lippincott Williams and Wilkins, Philadelphia

    Google Scholar 

  • Briggs GG, Freeman RK, Yaffe SJ (2011) Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk, 9th edn. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  • Carmichael SL, Shaw GM (1999) Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet 86(3):242–244

    CAS  PubMed  Google Scholar 

  • Cassina M, Johnson DL, Robinson LK, Braddock SR, Xu R, Jimenez JL, Mirrasoul N, Salas E, Luo YJ, Jones KL, Chambers CD, Organization of Teratology Information Specialists Collaborative Research Group (2012) Pregnancy outcome in women exposed to leflunomide before or during pregnancy. Arthritis Rheum 64(7):2085–2094

    CAS  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (2012) Alcohol use and binge drinking among women of childbearing age-United States, 2006–2010. MMWR 61:534–538

    Google Scholar 

  • Chambers CD, Hernandez-Diaz S, Van Marter LJ, Werler MM, Louik C, Jones KL, Mitchell AA (2006) Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 354(6):579–587

    CAS  PubMed  Google Scholar 

  • Chambers CD, Johnson DL, Robinson LK, Braddock SR, Xu R, Lopez-Jimenez J, Mirrasoul N, Salas E, Luo YJ, Jin S, Jones KL, Organization of Teratology Information Specialists Collaborative Research Group (2010) Birth outcomes in women who have taken leflunomide during pregnancy. Arthritis Rheum 62(5):1494–1503

    PubMed Central  PubMed  Google Scholar 

  • Chan WS, Anand S, Ginsberg JS (2000) Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med 160(2):191–196

    CAS  PubMed  Google Scholar 

  • Choi JS, Han JY, Kim MY, Velázquez-Armenta EY, Nava-Ocampo AA (2007) Pregnancy outcomes in women using inhaled fluticasone during pregnancy: a case series. Allergol Immunopathol (Madr) 35(6):239–242

    CAS  Google Scholar 

  • Choi JS, Koren G, Nulman I (2013) Pregnancy and isotretinoin therapy. CMAJ 185(5):411–413

    PubMed Central  PubMed  Google Scholar 

  • Christensen LA, Dahlerup JF, Nielsen MJ, Fallingborg JF, Schmiegelow K et al (2008) Azathioprine treatment during lactation. Aliment Pharmacol Ther 28(10):1209–1213

    CAS  PubMed  Google Scholar 

  • Chung NA, Lip GY, Beevers M, Beevers DG (2001) Angiotensin-II-receptor inhibitors in pregnancy. Lancet 357(9268):1620–1621

    CAS  PubMed  Google Scholar 

  • Cleary BJ, Källén B (2009) Early pregnancy azathioprine use and pregnancy outcomes. Birth Defects Res A Clin Mol Teratol 85(7):647–654

    CAS  PubMed  Google Scholar 

  • Coscia LA, Constantinescu S, Moritz MJ, Frank AM, Ramirez CB, Maley WR, Doria C, McGrory CH, Armenti VT (2010) Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl 2010:65–85

    Google Scholar 

  • Costei AM, Kozer E, Ho T, Ito S, Koren G (2002) Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med 156(11):1129–1132

    PubMed  Google Scholar 

  • Cotrufo M, De Feo M, De Santo LS, Romano G, Della Corte A, Renzulli A, Gallo C (2002) Risk of warfarin during pregnancy with mechanical valve prostheses. Obstet Gynecol 99(1):35–40

    CAS  PubMed  Google Scholar 

  • Coulam CB, Moyer TP, Jiang NS, Zincke H (1982) Breast-feeding after renal transplantation. Transplant Proc 14(3):605–609

    CAS  PubMed  Google Scholar 

  • Cox RM, Anderson JM, Cox P (2003) Defective embryogenesis with angiotensin II receptor antagonists in pregnancy. BJOG 110(11):1038

    CAS  PubMed  Google Scholar 

  • Czeizel AE, Rockenbauer M (1997) Population-based case-control study of teratogenic potential of corticosteroids. Teratology 56(5):335–340

    CAS  PubMed  Google Scholar 

  • da Silva Dal Pizzol T, Knop FP, Mengue SS (2006) Prenatal exposure to misoprostol and congenital anomalies: systematic review and meta-analysis. Reprod Toxicol 22(4):666–671

    CAS  PubMed  Google Scholar 

  • Davison JM, Dellagrammatikas H, Parkin JM (1985) Maternal azathioprine therapy and depressed haemopoiesis in the babies of renal allograft patients. Br J Obstet Gynaecol 92(3):233–239

    CAS  PubMed  Google Scholar 

  • Devlin RG, Fleiss PM (1981) Captopril in human blood and breast milk. J Clin Pharmacol 21(2):110–113

    CAS  PubMed  Google Scholar 

  • DeWitte DB, Buick MK, Cyran SE, Maisels MJ (1984) Neonatal pancytopenia and severe combined immunodeficiency associated with antenatal administration of azathioprine and prednisone. J Pediatr 105(4):625–628

    CAS  PubMed  Google Scholar 

  • Diav-Citrin O, Shechtman S, Halberstadt Y, Finkel-Pekarsky V, Wajnberg R, Arnon J, Di Gianantonio E, Clementi M, Ornoy A (2011) Pregnancy outcome after in utero exposure to angiotensin converting enzyme inhibitors or angiotensin receptor blockers. Reprod Toxicol 31(4):540–545

    CAS  PubMed  Google Scholar 

  • Einarson A, Choi J, Einarson TR, Koren G (2009) Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. J Obstet Gynaecol Can 31(5):452–456

    PubMed  Google Scholar 

  • Einarson A, Choi J, Einarson TR, Koren G (2010) Adverse effects of antidepressant use in pregnancy: an evaluation of fetal growth and preterm birth. Depress Anxiety 27(1):35–38

    CAS  PubMed  Google Scholar 

  • Einarson A, Smart K, Vial T, Diav-Citrin O, Yates L, Stephens S, Pistelli A, Kennedy D, Taylor T, Panchaud A, Malm H, Koren G, Einarson TR (2012) Rates of major malformations in infants following exposure to duloxetine during pregnancy: a preliminary report. J Clin Psychiatry 73(11):1471

    PubMed  Google Scholar 

  • Engeland A, Bramness JG, Daltveit AK et al (2008) Prescription drug use among fathers and mothers before and during pregnancy. A population-based cohort study of 106,000 pregnancies in Norway 2004Y2006. Br J Clin Pharmacol 65(5):653–660

    PubMed Central  PubMed  Google Scholar 

  • Eriksson K, Viinikainen K, Mönkkönen A, Aikiä M, Nieminen P, Heinonen S, Kälviäinen R (2005) Children exposed to valproate in utero–population based evaluation of risks and confounding factors for long-term neurocognitive development. Epilepsy Res 65(3):189–200

    CAS  PubMed  Google Scholar 

  • Ethen MK, Ramadhani TA, Scheuerle AE, Canfield MA, Wyszynski DF, Druschel CM, Romitti PA (2009) Alcohol consumption by women before and during pregnancy. Matern Child Health J 13:274–285

    PubMed  Google Scholar 

  • Fabro S, Scialli AR (1986) Drug and chemical action in pregnancy: pharmacologic and toxicologic principles. M. Dekker, New York

    Google Scholar 

  • Finch E, Lorber J (1954) Methaemoglobinaemia in the newborn probably due to phenytoin excreted in human milk. J Obstet Gynaecol Br Emp 61(6):833–834

    CAS  PubMed  Google Scholar 

  • Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee, Briefing Document for Ustekinumab (CNTO 1275). http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4361b1-02-CENTOCOR.pdf. Accessed 15 Oct 2012

  • French NP, Hagan R, Evans SF et al (1999) Repeated antenatal corticosteroids: size at birth and subsequent development. Am J Obstet Gynecol 180:114

    CAS  PubMed  Google Scholar 

  • Froescher W, Eichelbaum M, Niesen M, Dietrich K, Rausch P (1984) Carbamazepine levels in breast milk. Ther Drug Monit 6(3):266–271

    CAS  PubMed  Google Scholar 

  • From the Centers for Disease Control and Prevention (1997) Postmarketing surveillance for angiotensin-converting enzyme inhibitor use during the first trimester of pregnancy – United States, Canada, and Israel, 1987–1995. JAMA 277(15):1193–1194

    Google Scholar 

  • Gaily E, Kantola-Sorsa E, Hiilesmaa V, Isoaho M, Matila R, Kotila M, Nylund T, Bardy A, Kaaja E, Granström ML (2004) Normal intelligence in children with prenatal exposure to carbamazepine. Neurology 62(1):28–32

    CAS  PubMed  Google Scholar 

  • Gersak K, Cvijic M, Cerar LK (2009) Angiotensin II receptor blockers in pregnancy: a report of five cases. Reprod Toxicol 28(1):109–112

    CAS  PubMed  Google Scholar 

  • Giles JJ, Bannigan JG (2006) Teratogenic and developmental effects of lithium. Curr Pharm Des 12(12):1531–1541

    CAS  PubMed  Google Scholar 

  • Goldstein LH, Dolinsky G, Greenberg R, Schaefer C, Cohen-Kerem R, Diav-Citrin O, Malm H, Reuvers-Lodewijks ME, Rost van Tonningen-van Driel MM, Arnon J, Ornoy A, Clementi M, Di Gianantonio E, Koren G, Braunstein R, Berkovitch M (2007) Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol 79(10):696–701

    CAS  PubMed  Google Scholar 

  • Gonzalez CH, Vargas FR, Perez AB, Kim CA, Brunoni D, Marques-Dias MJ, Leone CR, Correa Neto J, Llerena Júnior JC, de Almeida JC (1993) Limb deficiency with or without Möbius sequence in seven Brazilian children associated with misoprostol use in the first trimester of pregnancy. Am J Med Genet 47(1):59–64

    CAS  PubMed  Google Scholar 

  • Gram L, Bentsen KD (1985) Valproate: an updated review. Acta Neurol Scand 72(2):129–139

    CAS  PubMed  Google Scholar 

  • Greenberger PA, Patterson R (1983) Beclomethasone diproprionate for severe asthma during pregnancy. Ann Intern Med 98(4):478–480

    CAS  PubMed  Google Scholar 

  • Guignard JP, Burgener F, Calame A (1981) Persistent anuria in a neonate: a side effect of captopril. Int J Pediatr Nephrol 2:133

    Google Scholar 

  • Gur C, Diav-Citrin O, Shechtman S, Arnon J, Ornoy A (2004) Pregnancy outcome after first trimester exposure to corticosteroids: a prospective controlled study. Reprod Toxicol 18(1):93–101

    CAS  PubMed  Google Scholar 

  • Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ (2012) American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):7S–47S. doi:10.1378/chest.1412S3. No abstract available

  • Haastrup MB, Pottegard A, Damkier P (2014) Alcohol and breastfeeding. Basic Clin Pharmacol Toxicol 114(2):168–173

    CAS  PubMed  Google Scholar 

  • Hajdyla-Banaś I, Banas T, Rydz-Stryszowska I, Batko B, Skura A, Górnisiewicz T, Pityńska-Korab E (2009) Pregnancy course and neonatal outcome after exposure to leflunomide–2 cases report and review of literature. Przegl Lek 66(12):1069–1071

    PubMed  Google Scholar 

  • Hall JG, Pauli RM, Wilson KM (1980) Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 68(1):122–140

    CAS  PubMed  Google Scholar 

  • Harden CL, Meador KJ, Pennell PB, Hauser WA, Gronseth GS, French JA, Wiebe S, Thurman D, Koppel BS, Kaplan PW, Robinson JN, Hopp J, Ting TY, Gidal B, Hovinga CA, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Hirtz D, Le Guen C, American Academy of Neurology, American Epilepsy Society (2009) Management issues for women with epilepsy-focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia 50(5):1237–1246

    PubMed  Google Scholar 

  • Harrod MJ, Sherrod PS (1981) Warfarin embryopathy in siblings. Obstet Gynecol 57(5):673–676

    CAS  PubMed  Google Scholar 

  • Heinonen OP, Slone D, Shapiro S (1977) Birth defects and drugs in pregnancy. Publishing Sciences Group, Littleton, Massachusetts

    Google Scholar 

  • Ho E, Collantes A, Kapur BM, Moretti M, Koren G (2001) Alcohol and breast feeding: calculation of time to zero level in milk. Biol Neonate 80(3):219–222

    CAS  PubMed  Google Scholar 

  • Hoeltzenbein M, Elefant E, Vial T, Finkel-Pekarsky V, Stephens S, Clementi M, Allignol A, Weber-Schoendorfer C, Schaefer C (2012) Teratogenicity of mycophenolate confirmed in a prospective study of the European Network of Teratology Information Services. Am J Med Genet A 158A(3):588–596

    PubMed  Google Scholar 

  • Holmes LB, Rosenberger PB, Harvey EA, Khoshbin S, Ryan L (2000) Intelligence and physical features of children of women with epilepsy. Teratology 61(3):196–202

    CAS  PubMed  Google Scholar 

  • Holmes LB, Harvey EA, Coull BA, Huntington KB, Khoshbin S, Hayes AM, Ryan LM (2001) The teratogenicity of anticonvulsant drugs. N Engl J Med 344(15):1132–1138

    CAS  PubMed  Google Scholar 

  • Huttunen K, Grönhagen-Riska C, Fyhrquist F (1989) Enalapril treatment of a nursing with slightly impaired renal function. Clin Nephrol 31(5):278

    CAS  PubMed  Google Scholar 

  • Iturbe-Alessio I, Fonseca MC, Mutchinik O, Santos MA, Zajarías A, Salazar E (1986) Risks of anticoagulant therapy in pregnant women with artificial heart valves. N Engl J Med 315(22):1390–1393

    CAS  PubMed  Google Scholar 

  • Jentink J, Loane MA, Dolk H, Barisic I, Garne E, Morris JK, de Jong-van den Berg LT, EUROCAT Antiepileptic Study Working Group (2010) Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med 362(23):2185–2193

    CAS  PubMed  Google Scholar 

  • Johnson D, Luo Y, Jones KL, Chambers C (2011) Pregnancy outcomes in women exposed to Adalimumab: an update on the autoimmune diseases in pregnancy project. Arthritis Rheum 63(Suppl 10):1874 [abstract]

    Google Scholar 

  • Jones KL, Smith DW, Ulleland CN, Streissguth P (1973) Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 1(7815):1267–1271

    CAS  PubMed  Google Scholar 

  • Jong GW, Einarson T, Koren G, Einarson A (2012) Antidepressant use in pregnancy and persistent pulmonary hypertension of the newborn (PPHN): a systematic review. Reprod Toxicol 34(3):293–297

    PubMed  Google Scholar 

  • Kaaja E, Kaaja R, Hiilesmaa V (2003) Major malformations in offspring of women with epilepsy. Neurology 60(4):575–579

    PubMed  Google Scholar 

  • Källén B, Olausson PO (2008) Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 17(8):801–806

    PubMed  Google Scholar 

  • Källén B, Otterblad OP (2007) Use of anti-asthmatic drugs during pregnancy. 3. Congenital malformations in the infants. Eur J Clin Pharmacol 63(4):383–388

    PubMed  Google Scholar 

  • Källén B, Tandberg A (1983) Lithium and pregnancy. A cohort study on manic-depressive women. Acta Psychiatr Scand 68(2):134–139

    PubMed  Google Scholar 

  • Kaneko S, Sato T, Suzuki K (1979) The levels of anticonvulsants in breast milk. Br J Clin Pharmacol 7(6):624–627

    CAS  PubMed Central  PubMed  Google Scholar 

  • Kaneko S, Suzuki K, Sato T et al (1982) The problems of antiepileptic medication in the neonatal period: is breast-feeding advisable? In: Janz D, Dam M, Richens A et al (eds) Epilepsy, pregnancy and the child. Raven, New York, pp 343–348

    Google Scholar 

  • Karlsson K, Lindstedt G, Lundberg PA, Selstam U (1975) Letter: transplacental lithium poisoning: reversible inhibition of fetal thyroid. Lancet 1(7919):1295

    CAS  PubMed  Google Scholar 

  • Kato K, Okuda M, Ishikawa H, Takahashi T, Hirahara F (2008) Oligohydramnios and pulmonary hypoplasia: a case in which involvement of an angiotensin II receptor antagonist was suspected. J Obstet Gynaecol Res 34(2):242–246

    PubMed  Google Scholar 

  • Kelly LE, Chaudhry SA, Rieder MJ et al (2013) A clinical tool for reducing central nervous system depression among neonates exposed to codeine through breast milk. PLoS One 8:e70073

    CAS  PubMed Central  PubMed  Google Scholar 

  • Kieler H, Artama M, Engeland A, Ericsson O, Furu K, Gissler M, Nielsen RB, Nørgaard M, Stephansson O, Valdimarsdottir U, Zoega H, Haglund B (2012) Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ 344:d8012

    PubMed  Google Scholar 

  • Kok TH, Taitz LS, Bennett MJ, Holt DW (1982) Drowsiness due to clemastine transmitted in breast milk. Lancet 1(8277):914–915

    CAS  PubMed  Google Scholar 

  • Koren G (2013) Treating the mother, protecting the unborn: the motherisk approach. J Pediatr Pharmacol Ther 18(1):4–7

    PubMed Central  PubMed  Google Scholar 

  • Koren G, Nordeng H (2011) SSRIs and persistent pulmonary hypertension of the newborn. BMJ 344:d7642

    PubMed  Google Scholar 

  • Koren G, Nordeng H (2012) Antidepressant use during pregnancy: the benefit-risk ratio. Am J Obstet Gynecol 207(3):157–163

    PubMed  Google Scholar 

  • Koren G, Nordeng HM (2013) Selective serotonin reuptake inhibitors and malformations: case closed? Semin Fetal Neonatal Med 18(1):19–22

    PubMed  Google Scholar 

  • Koren G, Pastuszak A, Ito S (1998) Drugs in pregnancy. N Engl J Med 338(16):1128–1137

    CAS  PubMed  Google Scholar 

  • Koren G, Avner M, Shear N (2004) Generic isotretinoin: a new risk for unborn children. CMAJ 170(10):1567–1568

    PubMed Central  PubMed  Google Scholar 

  • Koren G, Nava-Ocsmpo AA, Moretti ME et al (2006) Major malformations with valproic acid. Can Fam Physician 52:441–447

    PubMed Central  PubMed  Google Scholar 

  • Kozlowski RD, Steinbrunner JV, MacKenzie AH, Clough JD, Wilke WS, Segal AM (1990) Outcome of first-trimester exposure to low-dose methotrexate in eight patients with rheumatic disease. Am J Med 88(6):589–592

    CAS  PubMed  Google Scholar 

  • Krause S, Ebbesen F, Lange AP (1990) Polyhydramnios with maternal lithium treatment. Obstet Gynecol 75(3 Pt 2):504–506

    CAS  PubMed  Google Scholar 

  • Kreft-Jais C, Plouin PF, Tchobroutsky C, Boutroy MJ (1988) Angiotensin-converting enzyme inhibitors during pregnancy: a survey of 22 patients given captopril and nine given enalapril. Br J Obstet Gynaecol 95(4):420–422

    CAS  PubMed  Google Scholar 

  • Kristensen JH, Ilett KF, Hackett LP et al (1999) Distribution and excretion of fluoxetine and norfluoxetine in human milk. Br J Clin Pharmacol 48:521–527

    CAS  PubMed Central  PubMed  Google Scholar 

  • Kuhnz W, Jager-Roman E, Rating DH et al (1983) Carbamazepine and carbamazepine 10,11-epoxide during pregnancy and postnatal period in epileptic mothers and their nursed infants and their effects on neonatal behavior. Pediatr Pharmacol (New York) 3:199–208

    CAS  Google Scholar 

  • Kwan LY, Mahadevan U (2010) Inflammatory bowel disease and pregnancy: an update. Expert Rev Clin Immunol 6(4):643–657

    PubMed  Google Scholar 

  • Lambot MA, Vermeylen D, Noël JC (2001) Angiotensin-II-receptor inhibitors in pregnancy. Lancet 357(9268):1619–1620

    CAS  PubMed  Google Scholar 

  • Lammer EJ, Chen DT, Hoar RM et al (1985) Retinoic acid embryopathy. N Engl J Med 313(14):837–841

    CAS  PubMed  Google Scholar 

  • Lammer EJ, Sever LE, Oakley GP Jr (1987) Teratogen update: valproic acid. Teratology 35(3):465–473

    CAS  PubMed  Google Scholar 

  • Lanza di Scalea T, Wisner KL (2009) Antidepressant medication use during breastfeeding. Clin Obstet Gynecol 52:483–497

    PubMed  Google Scholar 

  • Lawton ME (1985) Alcohol in breast milk. Aust N Z J Obstet Gynaecol 25(1):71–73

    CAS  PubMed  Google Scholar 

  • Lee E, Maneno MK, Smith L et al (2006) National patterns of medication use during pregnancy. Pharmacoepidemiol Drug Saf 15(8):537–545

    PubMed  Google Scholar 

  • Levinson-Castiel R, Merlob P, Linder N, Sirota L, Klinger G (2006) Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 160(2):173–176

    PubMed  Google Scholar 

  • Lewden B, Vial T, Elefant E, Nelva A, Carlier P, Descotes J, French Network of Regional Pharmacovigilance Centers (2004) Low dose methotrexate in the first trimester of pregnancy: results of a French collaborative study. J Rheumatol 31(12):2360–2365

    CAS  PubMed  Google Scholar 

  • Lewis AJ, Galbally M, Opie G, Buist A (2010) Neonatal growth outcomes at birth and one month postpartum following in utero exposure to antidepressant medication. Aust N Z J Psychiatry 44(5):482–487

    PubMed  Google Scholar 

  • Li DK, Yang C, Andrade S, Tavares V, Ferber JR (2011) Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: a retrospective cohort study. BMJ 343:d5931

    PubMed Central  PubMed  Google Scholar 

  • Lim A, Stewart K, König K, George J (2011) Systematic review of the safety of regular preventive asthma medications during pregnancy. Ann Pharmacother 45(7–8):931–945

    CAS  PubMed  Google Scholar 

  • Lindhout D, Omtzigt JG (1992) Pregnancy and the risk of teratogenicity. Epilepsia 33(Suppl 4):S41–S48

    PubMed  Google Scholar 

  • Lindhout D, Höppener RJ, Meinardi H (1984) Teratogenicity of antiepileptic drug combinations with special emphasis on epoxidation (of carbamazepine). Epilepsia 25(1):77–83

    CAS  PubMed  Google Scholar 

  • Lip GY, Churchill D, Beevers M, Auckett A, Beevers DG (1997) Angiotensin-converting-enzyme inhibitors in early pregnancy. Lancet 350(9089):1446–1447

    CAS  PubMed  Google Scholar 

  • Little RE, Anderson KW, Ervin CH, Worthington-Roberts B, Clarren SK (1989) Maternal alcohol use during breast-feeding and infant mental and motor development at one year. N Eng J Med 321(7):425–430

    CAS  Google Scholar 

  • Livingston S (1956) Treatment of epilepsy with diphenylhydantoin sodium (Dilantin sodium). Postgrad Med 20:584–586

    CAS  PubMed  Google Scholar 

  • Madadi P, Moretti M, Djokanovic N et al (2009) Guidelines for maternal codeine use during breastfeeding. Can Fam Physician 55:1077–1078

    PubMed Central  PubMed  Google Scholar 

  • Mahadevan U, Kane S, Sandborn WJ, Cohen RD, Hanson K, Terdiman JP, Binion DG (2005) Intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn’s disease. Aliment Pharmacol Ther 21(6):733–738

    CAS  PubMed  Google Scholar 

  • Mahadevan U, Cucchiara S, Hyams JS, Steinwurz F, Nuti F, Travis SP, Sandborn WJ, Colombel JF (2011) The London Position Statement of the World Congress of Gastroenterology on biological therapy for IBD with the European Crohn’s and Colitis Organisation: pregnancy and pediatrics. Am J Gastroenterol 106(2):214–223

    CAS  PubMed  Google Scholar 

  • Mahadevan U, Martin CF, Sandler RS et al (2012) PIANO: a 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Gastroenterology 142(5 Suppl 1):S149

    Google Scholar 

  • Mahadevan U, Wolf DC, Dubinsky M, Cortot A, Lee SD, Siegel CA, Ullman T, Glover S, Valentine JF, Rubin DT, Miller J, Abreu MT (2013) Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 11(3):286–292

    CAS  PubMed Central  PubMed  Google Scholar 

  • Mann R, Mackay F, Pearce G, Freemantle S, Wilton L (1999) Losartan: a study of pharmacovigilance data on 14,522 patients. J Hum Hypertens 13(8):551–557

    CAS  PubMed  Google Scholar 

  • Marin M, Broder KR, Temte JL, Snider DE, Seward JF, Centers for Disease Control and Prevention (CDC) (2010) Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 59(RR-3):1–12

    PubMed  Google Scholar 

  • Martín MC, Barbero P, Groisman B, Aguirre MÁ, Koren G (2014) Methotrexate embryopathy after exposure to low weekly doses in early pregnancy. Reprod Toxicol 43:26–29

    PubMed  Google Scholar 

  • Matalon S, Schechtman S, Goldzweig G, Ornoy A (2002) The teratogenic effect of carbamazepine: a meta-analysis of 1255 exposures. Reprod Toxicol 16(1):9–17

    CAS  PubMed  Google Scholar 

  • Matlow J, Koren G (2012) Is carbamazepine safe to take during pregnancy? Can Fam Physician 58(2):163–164

    PubMed Central  PubMed  Google Scholar 

  • McBride WG (1978) Teratogenic action of thalidomide. Lancet 1(8078):1362

    CAS  PubMed  Google Scholar 

  • McVearry KM, Gaillard WD, VanMeter J, Meador KJ (2009) A prospective study of cognitive fluency and originality in children exposed in utero to carbamazepine, lamotrigine, or valproate monotherapy. Epilepsy Behav 16(4):609–616

    PubMed Central  PubMed  Google Scholar 

  • Meador KJ, Baker GA, Browning N, Clayton-Smith J, Combs-Cantrell DT, Cohen M, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW, NEAD Study Group (2009) Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med 360(16):1597–1605

    CAS  PubMed Central  PubMed  Google Scholar 

  • Meador KJ, Baker GA, Browning N, Clayton-Smith J, Combs-Cantrell DT, Cohen M, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW, NEAD Study Group (2010) Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology 75(22):1954–1960

    CAS  PubMed Central  PubMed  Google Scholar 

  • Mennella JA, Beauchamp GK (1991) The transfer of alcohol to human milk. Effects on flavor and the infant’s behavior. N Eng J Med 325(14):981–985

    CAS  Google Scholar 

  • Mennella JA, Gerrish CJ (1998) Effects of exposure to alcohol in mother’s milk on infant sleep. Pediatrics 101(5):E2

    CAS  PubMed  Google Scholar 

  • Mercer B, Egerman R, Beazley D et al (2001) Steroids reduce fetal growth: analysis of a prospective trial. Am J Obstet Gynecol 184:S7

    Google Scholar 

  • Merlob P, Stahl B, Klinger G (2009) Tetrada of the possible mycophenolate mofetil embryopathy: a review. Reprod Toxicol 28(1):105–108

    CAS  PubMed  Google Scholar 

  • Michaud CM, McKenna MT, Begg S, Tomijima N, Majmudar M, Bulzacchelli MT, Ebrahim S, Ezzati M, Salomon JA, Kreiser JG, Hogan M, Murray CJ (2006) The burden of disease and injury in the United States, 1996. Popul Health Metrics 4(4):11

    Google Scholar 

  • Mirkin BL (1971) Diphenylhydantoin: placental transport, fetal localization, neonatal metabolism, and possible teratogenic effects. J Pediatr 78(2):329–337

    CAS  PubMed  Google Scholar 

  • Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernández-Díaz S (2011) Medication use during pregnancy, with particular focus on prescription drugs: 1976–2008. Am J Obstet Gynecol 205(1):51.e1–51.e8

    Google Scholar 

  • Mizrahi EM, Hobbs JF, Goldsmith DI (1979) Nephrogenic diabetes insipidus in transplacental lithium intoxication. J Pediatr 94(3):493–495

    CAS  PubMed  Google Scholar 

  • Moretti ME, Koren G (2001) Motherisk: the Toronto model for counseling in reproductive toxicology. In: Koren G (ed) Maternal-fetal toxicology – a clinician’s guide, 3rd edn. Marcel Dekker, New York, pp 767–788

    Google Scholar 

  • Moretti ME, Sharma A, Bar-Oz B et al (1999) Fluoxetine and its effects on the nursing infant: a prospective cohort. Clin Pharmacol Ther 65:141, Abstract

    Google Scholar 

  • Moretti ME, Koren G, Verjee Z, Ito S (2003) Monitoring lithium in breast milk: an individualized approach for breast-feeding mothers. Ther Drug Monit 25(3):364–366

    CAS  PubMed  Google Scholar 

  • Moretti ME, Caprara D, Drehuta I, Yeung E, Cheung S, Federico L, Koren G (2012) The fetal safety of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Obstet Gynecol Int 2012:658310

    PubMed Central  PubMed  Google Scholar 

  • Morgan SL, Baggott JE, Vaughn WH, Young PK, Austin JV, Krumdieck CL, Alarcón GS (1990) The effect of folic acid supplementation on the toxicity of low-dose methotrexate in patients with rheumatoid arthritis. Arthritis Rheum 33(1):9–18

    CAS  PubMed  Google Scholar 

  • Morrow J, Russell A, Guthrie E, Parsons L, Robertson I, Waddell R, Irwin B, McGivern RC, Morrison PJ, Craig J (2006) Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry 77(2):193–198

    CAS  PubMed Central  PubMed  Google Scholar 

  • Moses-Kolko EL, Bogen D, Perel J, Bregar A, Uhl K, Levin B, Wisner KL (2005) Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 293(19):2372–2383

    CAS  PubMed  Google Scholar 

  • Moskovitz DN, Bodian C, Chapman ML, Marion JF, Rubin PH, Scherl E, Present DH (2004) The effect on the fetus of medications used to treat pregnant inflammatory bowel-disease patients. Am J Gastroenterol 99(4):656–661

    PubMed  Google Scholar 

  • Mountain KR, Hirsh J, Gallus AS (1970) Neonatal coagulation defect due to anticonvulsant drug treatment in pregnancy. Lancet 1(7641):265–268

    CAS  PubMed  Google Scholar 

  • Mowat C, Cole A, Windsor A, Ahmad T, Arnott I, Driscoll R, Mitton S, Orchard T, Rutter M, Younge L, Lees C, Ho GT, Satsangi J, Bloom S (2011) Guidelines for the management of inflammatory bowel disease in adults. Gut 60(5):571–607

    PubMed  Google Scholar 

  • Murashima A, Watanabe N, Ozawa N, Saito H, Yamaguchi K (2009) Etanercept during pregnancy and lactation in a patient with rheumatoid arthritis: drug levels in maternal serum, cord blood, breast milk and the infant’s serum. Ann Rheum Dis 68(11):1793–1794

    CAS  PubMed  Google Scholar 

  • Nahum GG, Uhl K, Kennedy DL (2006) Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol 107(5):1120–1138

    CAS  PubMed  Google Scholar 

  • Nakhai-Pour HR, Broy P, Bérard A (2010) Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 182(10):1031–1037

    PubMed Central  PubMed  Google Scholar 

  • Nauta M, Landsmeer ML, Koren G (2009) Codeine-acetaminophen versus nonsteroidal anti-inflammatory drugs in the treatment of post-abdominal surgery pain: a systematic review of randomized trials. Am J Surg 198:256–261

    CAS  PubMed  Google Scholar 

  • Newport DJ, Viguera AC, Beach AJ, Ritchie JC, Cohen LS, Stowe ZN (2005) Lithium placental passage and obstetrical outcome: implications for clinical management during late pregnancy. Am J Psychiatry 162(11):2162–2170

    PubMed  Google Scholar 

  • Newport DJ, Ritchie JC, Knight BT et al (2009) Venlafaxine in human breast milk and nursing infant plasma: determination of exposure. J Clin Psychiatry 7(9):1304–1310

    Google Scholar 

  • Occhiogrosso M, Omran SS, Altemus M (2012) Persistent pulmonary hypertension of the newborn and selective serotonin reuptake inhibitors: lessons from clinical and translational studies. Am J Psychiatry 169(2):134–140

    PubMed  Google Scholar 

  • Ojeda-Uribe M, Gilliot C, Jung G, Drenou B, Brunot A (2006) Administration of rituximab during the first trimester of pregnancy without consequences for the newborn. J Perinatol 26(4):252–255

    CAS  PubMed  Google Scholar 

  • Park-Wyllie L, Mazzotta P, Pastuszak A, Moretti ME, Beique L, Hunnisett L, Friesen MH, Jacobson S, Kasapinovic S, Chang D, Diav-Citrin O, Chitayat D, Nulman I, Einarson TR, Koren G (2000) Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 62(6):385–392

    CAS  PubMed  Google Scholar 

  • Pastuszak A, Koren G, Rieder MJ (1994) Use of the retinoid pregnancy prevention program in Canada: patterns of contraception use in women treated with isotretinoin and etretinate. Reprod Toxicol 8(1):63–68

    CAS  PubMed  Google Scholar 

  • Pastuszak AL, Schüler L, Speck-Martins CE, Coelho KE, Cordello SM, Vargas F, Brunoni D, Schwarz IV, Larrandaburu M, Safattle H, Meloni VF, Koren G (1998) Use of misoprostol during pregnancy and Möbius’ syndrome in infants. N Engl J Med 338(26):1881–1885

    CAS  PubMed  Google Scholar 

  • Pediatric Academic Societies’ annual meeting. 4–7 May 2002, Baltimore. Pediatr Res 2002;51(4 Suppl):1A-591A

    Google Scholar 

  • Perez-Aytes A, Ledo A, Boso V, Carey JC, Castell M, Vento M (2010) Immunosuppressive drugs and pregnancy: mycophenolate mofetil embryopathy. NeoReviews 11:e578–e589

    Google Scholar 

  • Pinelli JM, Symington AJ, Cunningham KA, Paes BA (2002) Case report and review of the perinatal implications of maternal lithium use. Am J Obstet Gynecol 187(1):245–249

    PubMed  Google Scholar 

  • Pinsky L, Digeorge AM (1965) Cleft palate in the mouse: a teratogenic index of glucocorticoid potency. Science 147(3656):402–403

    CAS  PubMed  Google Scholar 

  • Pirson Y, Van Lierde M, Ghysen J, Squifflet JP, Alexandre GP, van Ypersele de Strihou C (1985) Retardation of fetal growth in patients receiving immunosuppressive therapy. N Engl J Med 313(5):328

    CAS  PubMed  Google Scholar 

  • Rahimi R, Nikfar S, Abdollahi M (2006) Meta-analysis finds use of inhaled corticosteroids during pregnancy safe: a systematic meta-analysis review. Hum Exp Toxicol 25(8):447–452

    CAS  PubMed  Google Scholar 

  • Rampono J, Hackett LP, Kristensen JH et al (2006) Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk. Br J Clin Pharmacol 3:316–322

    Google Scholar 

  • Redman CW, Kelly JG, Cooper WD (1990) The excretion of enalapril and enalaprilat in human breast milk. Eur J Clin Pharmacol 38(1):99

    CAS  PubMed  Google Scholar 

  • Reinisch JM et al (1978) Prenatal exposure to prednisone in humans and animals retards intrauterine growth. Science 202:436–438

    CAS  PubMed  Google Scholar 

  • Reis M, Källén B (2010) Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med 40:1723–1733

    CAS  PubMed  Google Scholar 

  • Riggin L, Frankel Z, Moretti M, Pupco A, Koren G (2013) The fetal safety of fluoxetine: a systematic review and meta-analysis. J Obstet Gynaecol Can 35(4):362–369

    PubMed  Google Scholar 

  • Rodríguez-Pinilla E, Martínez-Frías ML (1998) Corticosteroids during pregnancy and oral clefts: a case-control study. Teratology 58(1):2–5

    PubMed  Google Scholar 

  • Rosa FW (1991) Spina bifida in infants of women treated with carbamazepine during pregnancy. N Engl J Med 324(10):674–677

    CAS  PubMed  Google Scholar 

  • Rosa FW, Bosco LA, Graham CF, Milstien JB, Dreis M, Creamer J (1989) Neonatal anuria with maternal angiotensin-converting enzyme inhibition. Obstet Gynecol 74(3 Pt 1):371–374

    CAS  PubMed  Google Scholar 

  • Rosett HL, Ouellette EM, Weiner L, Owens E (1978) Therapy of heavy drinking during pregnancy. Obstet Gynecol 51(1):41–46

    CAS  PubMed  Google Scholar 

  • Rossett HL, Weiner L (1984) Alcohol and the fetus: a clinical perspective. Oxford University Press, New York

    Google Scholar 

  • Rush JE, Snyder DL, Barrish A et al (1989) Comment on Huttunen K, Gronhagen-Riska C, Fyrquist F. Enalapril treatment of a nursing mother with slightly impaired renal function. Clin Nephrol 31:278

    Google Scholar 

  • Sachs HC, Committee On Drugs (2013) The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics 132(3):e796–e809

    PubMed  Google Scholar 

  • Sachs HC, The American Academy of Pediatrics committee on Drugs (2013) The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics 132:e796–e809

    PubMed  Google Scholar 

  • Sahasranaman S, Howard D, Roy S (2008) Clinical pharmacology and pharmacogenetics of thiopurines. Eur J Clin Pharmacol 64(8):753–767

    CAS  PubMed  Google Scholar 

  • Santos RP, Pergolizzi JJ (2004) Transient neonatal jitteriness due to maternal use of sertraline (Zoloft). J Perinatol 24(6):392–394

    PubMed  Google Scholar 

  • Sau A, Clarke S, Bass J et al (2007) Azathioprine and breastfeeding-is it safe? BJOG 114:498–501, PMID: 17261122

    CAS  PubMed  Google Scholar 

  • Schaefer C (2003) Angiotensin II-receptor-antagonists: further evidence of fetotoxicity but not teratogenicity. Birth Defects Res A Clin Mol Teratol 67(8):591–594

    CAS  PubMed  Google Scholar 

  • Schou M (1976) What happened later to the lithium babies? A follow-up study of children born without malformations. Acta Psychiatr Scand 54(3):193–197

    CAS  PubMed  Google Scholar 

  • Schramm C, Herkel J, Beuers U, Kanzler S, Galle PR, Lohse AW (2006) Pregnancy in autoimmune hepatitis: outcome and risk factors. Am J Gastroenterol 101(3):556–560

    CAS  PubMed  Google Scholar 

  • Schuetze P, Das Eiden R, Chan AW (2002) The effects of alcohol in breast milk on infant behavioral state and mother-infant feeding interactions. Infancy 3:349–363

    Google Scholar 

  • Schwarz EB, Maselli J, Norton M, Gonzales R (2005) Prescription of teratogenic medications in United States ambulatory practices. Am J Med 118(11):1240–1249

    PubMed  Google Scholar 

  • Scolnik D, Nulman I, Rovet J, Gladstone D, Czuchta D, Gardner HA, Gladstone R, Ashby P, Weksberg R, Einarson T et al (1994) Neurodevelopment of children exposed in utero to phenytoin and carbamazepine monotherapy. JAMA 271(10):767–770

    CAS  PubMed  Google Scholar 

  • Scott JR (1977) Fetal growth retardation associated with maternal administration of immunosuppressive drugs. Am J Obstet Gynecol 128:668–676

    CAS  PubMed  Google Scholar 

  • Serreau R, Luton D, Macher MA, Delezoide AL, Garel C, Jacqz-Aigrain E (2005) Developmental toxicity of the angiotensin II type 1 receptor antagonists during human pregnancy: a report of 10 cases. BJOG 112(6):710–712

    CAS  PubMed  Google Scholar 

  • Shaw EB, Steinback HL (1968) Aminopterin-induced fetal malformation. Survival of infant after attempted abortion. Am J Dis Child 115(4):477–482

    CAS  PubMed  Google Scholar 

  • Simonetti GD, Baumann T, Pachlopnik JM, von Vigier RO, Bianchetti MG (2006) Non-lethal fetal toxicity of the angiotensin receptor blocker candesartan. Pediatr Nephrol 21(9):1329–1330

    PubMed  Google Scholar 

  • Steffensen FH, Nielsen GL, Sørensen HT, Olesen C, Olsen J (1998) Pregnancy outcome with ACE-inhibitor use in early pregnancy. Lancet 351(9102):596

    CAS  PubMed  Google Scholar 

  • Stowe ZN (2007) The use of mood stabilizers during breastfeeding. J Clin Psychiatry 68(Suppl 9):22–28

    PubMed  Google Scholar 

  • Teratology Society 51st annual meeting, 25–29 June 2011, Coronado. Abstracts. Birth Defects Res A Clin Mol Teratol 2011;91(5):305–420

    Google Scholar 

  • Thiersch JB (1952) Therapeutic abortions with a folic acid antagonist, 4-aminopteroylglutamic acid (4-amino P.G.A) administered by the oral route. Am J Obstet Gynecol 63(6):1298–1304

    CAS  PubMed  Google Scholar 

  • Thomas SV, Ajaykumar B, Sindhu K, Nair MK, George B, Sarma PS (2008) Motor and mental development of infants exposed to antiepileptic drugs in utero. Epilepsy Behav 13(1):229–236

    PubMed  Google Scholar 

  • Thorp JA, Jones PG, Knox E, Clark RH (2002) Does antenatal corticosteroid therapy affect birth weight and head circumference? Obstet Gynecol 99:101–108

    CAS  PubMed  Google Scholar 

  • Timmer A, McDonald JW, Macdonald JK (2007) Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 1, CD000478

    PubMed  Google Scholar 

  • US Food and Drug Administration (2007) Public Health Advisory. Use of codeine products in nursing mothers. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm054717.htm

  • Van Driel D, Wesseling J, Rosendaal FR, Odink RJ, Van der Veer E, Gerver WJ, Geven-Boere LM, Sauer PJ (2000) Growth until puberty after in utero exposure to coumarins. Am J Med Genet 95(5):438–443

    PubMed  Google Scholar 

  • van Driel D, Wesseling J, Sauer PJ, van Der Veer E, Touwen BC, Smrkovsky M (2001) In utero exposure to coumarins and cognition at 8 to 14 years old. Pediatrics 107(1):123–129

    PubMed  Google Scholar 

  • van Driel D, Wesseling J, Sauer PJ, Touwen BC, van der Veer E, Heymans HS (2002) Teratogen update: fetal effects after in utero exposure to coumarins overview of cases, follow-up findings, and pathogenesis. Teratology 66(3):127–140

    PubMed  Google Scholar 

  • Vauzelle C, Beghin D, Cournot MP, Elefant E (2013) Birth defects after exposure to misoprostol in the first trimester of pregnancy: prospective follow-up study. Reprod Toxicol 36:98–103

    CAS  PubMed  Google Scholar 

  • Veiby G, Engelsen BA, Gilhus NE (2013) Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding: a prospective cohort study on children of women with epilepsy. JAMA Neurol 70:1367–1374

    PubMed  Google Scholar 

  • Vendemmia M, Garcia-Méric P, Rizzotti A, Boubred F, Lacroze V, Liprandi A, Simeoni U (2005) Fetal and neonatal consequences of antenatal exposure to type 1 angiotensin II receptor-antagonists. J Matern Fetal Neonatal Med 18(2):137–140

    CAS  PubMed  Google Scholar 

  • Viguera AC, Newport DJ, Ritchie J, Stowe Z, Whitfield T, Mogielnicki J, Baldessarini RJ, Zurick A, Cohen LS (2007) Lithium in breast milk and nursing infants: clinical implications. Am J Psychiatry 164(2):342–345

    PubMed  Google Scholar 

  • Ville Y, Jenkins E, Shearer MJ, Hemley H, Vasey DP, Layton M, Nicolaides KH (1993) Fetal intraventricular haemorrhage and maternal warfarin. Lancet 341(8854):1211

    CAS  PubMed  Google Scholar 

  • Vinten J, Adab N, Kini U, Gorry J, Gregg J, Baker GA, Liverpool and Manchester Neurodevelopment Study Group (2005) Neuropsychological effects of exposure to anticonvulsant medication in utero. Neurology 64(6):949–954

    CAS  PubMed  Google Scholar 

  • Vitale N, De Feo M, De Santo LS, Pollice A, Tedesco N, Cotrufo M (1999) Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol 33(6):1637–1641

    CAS  PubMed  Google Scholar 

  • Walfisch A, Al-maawali A, Moretti ME, Nickel C, Koren G (2011) Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers. J Obstet Gynaecol 31(6):465–472

    CAS  PubMed  Google Scholar 

  • Walker BE (1971) Induction of cleft palate in rats with antiinflammatory drugs. Teratology 4(1):39–42

    CAS  PubMed  Google Scholar 

  • Wesseling J, Van Driel D, Smrkovsky M, Van der Veer E, Geven-Boere LM, Sauer PJ, Touwen BC (2001) Neurological outcome in school-age children after in utero exposure to coumarins. Early Hum Dev 63(2):83–95

    CAS  PubMed  Google Scholar 

  • Wichman CL, Moore KM, Lang TR, St Sauver JL, Heise RH Jr, Watson WJ (2009) Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc 84(1):23–27

    PubMed Central  PubMed  Google Scholar 

  • Wilcox AJ, Baird DD, Weinberg CR (1999) Time of implantation of the conceptus and loss of pregnancy. New Eng J Med 340(23):1796–1799

    CAS  PubMed  Google Scholar 

  • Willmann S, Edginton AN, Coboeken K et al (2009) Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study. Clin Pharmacol Ther 86:634–643

    CAS  PubMed  Google Scholar 

  • Wilson KL, Zelig CM, Harvey JP, Cunningham BS, Dolinsky BM, Napolitano PG (2011) Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol 28(1):19–24

    PubMed  Google Scholar 

  • Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, Perel JM, Jones-Ivy S, Bodnar LM, Singer LT (2009) Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry 166(5):557–566

    PubMed  Google Scholar 

  • Wong V, Cheng CH, Chan KC (1993) Fetal and neonatal outcome of exposure to anticoagulants during pregnancy. Am J Med Genet 45(1):17–21

    CAS  PubMed  Google Scholar 

  • Wyszynski DF, Nambisan M, Surve T, Alsdorf RM, Smith CR, Holmes LB, Antiepileptic Drug Pregnancy Registry (2005) Increased rate of major malformations in offspring exposed to valproate during pregnancy. Neurology 64(6):961–965

    CAS  PubMed  Google Scholar 

  • Yip SK, Leung TN, Fung HY (1998) Exposure to angiotensin-converting enzyme inhibitors during first trimester: is it safe to fetus? Acta Obstet Gynecol Scand 77(5):570–571

    CAS  PubMed  Google Scholar 

  • Zelner I, Koren G (2013) Alcohol consumption among women. J Popul Ther Clin Pharmacol 20(2):e201–e206

    PubMed  Google Scholar 

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  1. The Motherisk Program, Clinical Pharmacology & Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

    Yifat Gadot & Gideon Koren

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  1. Yifat Gadot
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  2. Gideon Koren
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Correspondence to Gideon Koren .

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  1. Dean’s Department, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Mira Harrison-Woolrych

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Gadot, Y., Koren, G. (2015). Medication Use in Pregnancy; Treating the Mother: Protecting the Unborn. In: Harrison-Woolrych, M. (eds) Medicines For Women. Adis, Cham. https://doi.org/10.1007/978-3-319-12406-3_4

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  • DOI: https://doi.org/10.1007/978-3-319-12406-3_4

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-12405-6

  • Online ISBN: 978-3-319-12406-3

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