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The pregnancy category of a medication is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. It does not include any risks conferred by pharmaceutical agents or their metabolites in breast milk. Every drug has specific information listed in its product literature.
[96] [97] [98] In 2014, however, the FDA has developed a "Pregnancy and Lactation Labeling Rule (PLLR)" which requires product labels to include specific information related to the safety and effectiveness of medications to pregnant and lactating women. This ruling has removed the requirement of stating pregnancy categories in prescription drug ...
The degree of impact on the nursing infant varies, with many medications posing minimal risk. Nonetheless, informed decision-making and professional guidance is needed. The National Institutes of Health (NIH) maintains a database, which contains information on drugs and other chemicals to which breastfeeding mothers may be exposed.
Infections in pregnancy also raise particular concerns about whether or not to use drugs in pregnancy (that is, antibiotics or antivirals) to treat them. For example, pregnant women who contract H1N1 influenza infection are recommended to receive antiviral therapy with either oseltamivir (which is the preferred medication) or zanamivir. [11]
Depending on the tocolytic used, the pregnant woman or fetus may require monitoring (e.g., blood pressure monitoring when nifedipine is used as it reduces blood pressure; cardiotocography to assess fetal well-being). In any case, the risk of preterm labor alone justifies hospitalization.
Exposure to recreational drugs. Alcohol: Use during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorder. [67] Tobacco use: During pregnancy, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. [68] Also, it increases the odds of the baby being born prematurely by 30%. [69]
Some medications are so teratogenic that they are absolutely contraindicated in pregnancy; examples include thalidomide and isotretinoin. Relative contraindications are contraindications for circumstances in which the patient is at higher risk of complications from treatment, but these risks may be outweighed by other considerations or ...
A high-risk pregnancy is a pregnancy where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies; however, there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. [1]