Antenatal Exposure to Opioids May Increase the Risk of Neural Tube Defects
Previous studies have suggested a link between opioid exposure and increased risk of certain congenital malformations.
Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes
We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus. Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012). These deficits were the most prominent in children exposed to valproic acid.
Eating Disorders and Their Impact on Pregnancy Outcomes
Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse. There has been concern that eating disorders may negatively affect gestational weight gain. Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent.Â
New FDA Pregnancy Category Labeling: Still Waiting…
This is a very nice article published by the College of Psychiatric and Neurologic Pharmacists discussing the limitations of the current FDA pregnancy category labeling system.
SSRIs and Benzodiazepines: Reproductive Safety of Combined Treatment
Serotonin reuptake inhibitors (SSRIs) are frequently combined with benzodiazepines for the management of anxiety disorders or major depression with comorbid anxiety. While we have data regarding the reproductive safety of both the SSRIs and benzodiazepines, we have much less information on outcomes in women taking SSRIs and benzodiazepines together. A previous study (Oberlander 2008) found that neither the use of an SSRI alone nor the use of a benzodiazepine alone increased the risk for congenital malformation; however, in this study, the combined use of the two drugs increased the risk of cardiovascular defect. A recent study reassesses the risk of major malformation in women taking SSRIs combined with benzodiazepines.
Prevalence and Trends in the Use of Antipsychotic Medications during Pregnancy
Since their introduction in the 1990s, atypical (second-generation) antipsychotics have replaced typical (first generation) antipsychotics as the first-line treatment for schizophrenia and related psychotic disorders. These drugs are widely used by reproductive age women across many other disease states including bipolar disorder, major depression and anxiety disorders as either primary or adjunctive treatments.
Atypical Antipsychotic Medications: What Do We Know About Their Reproductive Safety?
Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety and long-term neurodevelopmental effects of these medications. A recent study assessed the development of 76 infants with fetal exposure to atypical antipsychotics.
SSRI Exposure During Pregnancy Does Not Appear to Affect Infant Growth
Some studies have shown an association between in utero exposure to antidepressants and various pregnancy outcomes, including preterm delivery, low birth weight, and lower Apgar scores; however, these outcomes have also been observed in infants born to depressed mothers who are not taking medication. Thus, it has been difficult to determine if there is a causal relationship between antidepressant exposure and these negative pregnancy outcomes or if untreated maternal depression is itself responsible for these negative outcomes.Â
Gabapentin (Neurontin) and Pregnancy
Despite the fact that gabapentin (Neurontin) is now used in a wide variety of clinical settings -- for epilepsy, pain management, anxiety, sleep disturbance – there is relatively little information regarding its reproductive safety. A prospective study from researchers at the Motherisk program reports on the outcomes of 223 pregnancies exposed to gabapentin and 223 unexposed pregnancies.
FDA Announces Approval of a New (Old) Medication for Nausea and Vomiting in Pregnancy
The combination of doxylamine succinate and pyridoxine hydrochloride (vitamin B6), to be marketed as Diclegis, has been approved by the FDA for the treatment of nausea and vomiting in pregnancy. A similar combination was previously sold under the name Bendectin but was pulled from the market in 1983 because there were concerns regarding its reproductive safety. (Bendectin originally contained dicyclomine which was later removed due to lack of efficacy.)