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CDC and its partners conduct important research on the effects of medications during pregnancy. Listed below are key findings from some of these studies and a list of articles that might be of interest. Click on the links to learn more about each study.
Highlighted Articles
Key Findings: Women and Healthcare Providers “Play it Safe” with Medicine Use During Pregnancy
A study from the Centers for Disease Control and Prevention (CDC), in collaboration with the March of Dimes and RTI International, found that women want to be actively engaged in making decisions about the medicines they take during pregnancy. However, there are not enough informational materials to tell women and their providers what medicines are safe to use during pregnancy.
Key Findings: Use of Pain Medicine During Early Pregnancy May Be Related To Birth Defects
A study from the Centers for Disease Control and Prevention (CDC) found that women who took NSAIDs and opioid pain medicines during early pregnancy were more likely to have babies affected with certain birth defects compared with women who took acetaminophen.
Key Findings: Antidepressant Prescription Claims among Reproductive-aged Women
CDC’s Morbidity and Mortality Weekly Report published a new study looking at how often women aged 15-44 years filled a prescription for an antidepressant medication.
Key Findings: Assessing YouTube Videos for Content on Medication Use during Pregnancy
The journal Pharmacoepidemiology and Drug Safety published a new study looking at the content of YouTube videos.
Key Findings: A Closer Look at the Link Between Specific SSRIs and Birth Defects
New CDC study findings refute some earlier reported links but confirm other links observed between birth defects and some selective serotonin reuptake inhibitors (SSRIs), which are medications used to treat depression and other mental health conditions.
Key Findings: Opioid Use among Women Aged 15-44
CDC researchers found that during 2008–2012, on average, 28% of women aged 15-44 years with private health insurance and 39% of women with Medicaid filled a prescription written by a healthcare provider for an opioid medication.
Key Findings: Opioid use and neural tube defects
The journal Obstetrics and Gynecology has published a new study that looked at the use of opioids during pregnancy and their relationship to having a pregnancy affected by a neural tube defect (NTD).
Key Findings: How much do we know about the most common medicines used during pregnancy?
In a new CDC study, researchers identified the medicines most commonly used by women during the first trimester (first three months) of pregnancy. They also looked at the gaps in information about the safety or risk of using these medicines during pregnancy.
Key Findings: Safe lists for medications in pregnancy- inadequate evidence base and inconsistent guidance from web-based information, 2011
A brief report looked at information and guidance on the internet about the safety of using medications during pregnancy.
Key Findings: Use of topiramate in pregnancy and risk of oral clefts
A new study looked at the risk of oral clefts among babies born to mothers who reported use of topiramate during the first trimester of pregnancy.
Maternal Treatment with Opioid Analgesics and Risk for Birth Defects
Opioid analgesics are prescription medications that commonly are used to treat severe pain. Two common opioid medications are codeine and oxycodone. Lower doses of opioids also might be included in some cough medicines. The effects of opioids on a pregnant woman and her unborn baby are not well understood.
Influencing Clinical Practice Regarding the Use of Antiepileptic Medications During Pregnancy
An introductory editorial article co-written by a CDC author is also in the special issue of this journal. This article gives a brief historical overview of the study of birth defects. It also highlights emerging topics that are discussed in the special issue.
Safe Medication Use During Pregnancy
Talk with your doctor if you are pregnant.
(Published: May 5, 2016)
Articles of Interest
* Articles are listed in order of date published, from the most recent
Medication Use during Pregnancy
Assessment of YouTube videos as a source of information for medication use in pregnancy.
Pharmacoepidemiol Drug Saf. 2016; 25: 35–44.
Hansen C, Interrante JD, Ailes EC, Frey MT, Broussard CS, Godoshian VJ, Lewis C, Polen KN, Garcia AP, & Gilboa SM.
[Read Article]
Medication use during pregnancy: evaluating risk is an ongoing challenge
British Medical Journal. 2014 Aug 21. [Epub ahead of print]
Cragan JD.
Developing a systematic approach to safer medication use during pregnancy: Summary of a Centers for Disease Control and Prevention-convened meeting
Am J Obstet Gynecol. 2014 May 29. [Epub ahead of print]
Broussard CS, Frey MT, Hernandez-Diaz S, Greene MF, Chambers CD, Sahin L, Collins Sharp BA, Honein MA.
[Read Summary]
The need for safer medication use in pregnancy
Expert Review of Clinical Pharmacology. 2013;6(5): 453-455.
Honein MA, Gilboa SM, Broussard CS.
[Read Summary]
Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk
Pharmacoepidemiol Drug Saf. 2013;22(9):1013-1018.
Thorpe PG, Gilboa SM, Hernandez-Diaz S, Lind J, Cragan JD, Briggs G, Kweder S, Friedman JM, Mitchell AA, Honein MA; National Birth Defects Prevention Study.
[Read Summary]
Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008
Am J Obstet Gynecol. 2011;205(1):51.e1-8.
Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernández-Díaz S; National Birth Defects Prevention Study.
[Read Summary] [Read Key Findings]
Use of over-the-counter medications during pregnancy
Am J Obstet Gynecol. 2005; 193(3 Pt 1):771-777.
Werler MM, Mitchell AA, Hernandez-Diaz S, Honein MA
[Read Summary]
Antidepressants
Using Insurance Claims Data to Identify and Estimate Critical Periods in Pregnancy: An Application to Antidepressants.
Birth Defects Res A Clin Mol Teratol. 2016 Nov; 106(11): 927-934.
Ailes EC, Simeone RM, Dawson AL, Peterson EE, and Gilboa SM.
[Read Article]
Antidepressant Prescription Claims among Reproductive-Aged Women – United States 2008-2013.
MMWR Morb Mortal Wkly Rep. 2016 Jan; 65(3):41–46.
Dawson AL, Ailes EC, Gilboa SM, Simeone RM, Lind JN, Farr SL, Broussard CS, Reefhuis J, Honein MA, Carrino G, Biermann, J.
[Read Article]
Specific SSRIs and birth defects: Bayesian analysis to interpret new data in the context of previous reports.
British Medical Journal. 2015; 351: h3190.
Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA, and the National Birth Defects Prevention Study.
[Read Article]
The association between reported venlafaxine use in early pregnancy and birth defects, National Birth Defects Prevention Study, 1997-2007.
Birth Defects Res A Clin Mol Teratol. 2013;97(1):28-35.
Polen KND, Rasmussen SA, Riehle-Colarusso T, Reefhuis J, & National Birth Defects Prevention Study.
[Read Summary]
Patterns of antidepressant medication use among pregnant women in a United States population
J Clin Pharmacol. 2011;51(2):264-270.
Alwan S, Reefhuis J, Rasmussen SA, Friedman JM, and the National Birth Defects Prevention Study.
[Read Article]
Maternal use of bupropion and risk for congenital heart defects
Am J Obstet Gynecol. 2010; 203(1):52.e1-6.
Alwan S, Reefhuis J, Botto LD, Rasmussen SA, Correa A, Friedman JM, and the National Birth Defects Prevention Study
[Read Summary]
Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects
N Engl J Med. 2007;356(26):2684-2692.
Alwan S, Reefhuis J, Rasmussen SA, Olney RS, Friedman JM for the National Birth Defects Prevention Study
[Read Article]
Selective serotonin-reuptake inhibitors (SSRIs) and persistent pulmonary hypertension of the newborn [letter]
N Engl J Med 2006; 354:2188-2190.
Reefhuis J, Rasmussen SA, Friedman JM.
[Read Letter]
Pain Medications
Incidence of Neonatal Abstinence Syndrome — 28 States, 1999–2013.
MMWR Morb Mortal Wkly Rep. 2016 Aug; 65(31): 799–802.
Ko J, Patrick S, Tong V, Patel R, Lind J, Barfield W.
[Read Article]
Opioid prescription claims among women of reproductive age – United States, 2008-2012.
MMWR Morb Mortal Wkly Rep. 2015 Jan 23;64(2):37-41.
Ailes EC, Dawson AL, Lind JN, Gillboa SM, Frey MT, Broussard CS, Honein MA; Centers for Disease Control and Prevention (CDC).
[Read Summary]
Case-Control Analysis of Maternal Prenatal Analgesic Use and Cardiovascular Malformations: Baltimore-Washington Infant Study
Am J Obstet Gynecol. 2014 Mar 26. [Epub ahead of print]
Marsh CA, Cragan JD, Alverson CJ, Correa A.
[Read Summary]
Periconceptional use of opioids and the risk of neural tube defects
Obstetrics and Gynecology. 2013;122(4):838-844.
Yazdy MM, Mitchell AA, Tinker SC, Parker SE, Werler MM.
[Read Summary]
Maternal drug use and its effect on neonates: a population-based study in Washington state
Obstet Gynecol. 2012;119(5):924-933.
Creanga AA, Sabel JC, Ko JY, Wasserman CR, Shapiro-Mendoza CK, Taylor P, Barfield W, Cawthon L, Paulozzi LJ.
[Read Summary]
Nonsteroidal antiinflammatory drug use among women and the risk of birth defects
Am J Obstet Gynecol. 2012;206(3):228 e221-228.
Hernandez RK, Werler MM, Romitti P, Sun L, Anderka M, National Birth Defects Prevention Study.
[Read Summary]
Maternal treatment with opioid analgesics and risk for birth defects
Am J Obstet Gynecol. 2011;204(4):314.e1-11.
Broussard CS, Rasmussen SA, Reefhuis J, Friedman JM, Jann MW, Riehle-Colarusso T, Honein MA; National Birth Defects Prevention Study.
[Read Summary] [Read Key Findings]
Acetaminophen use in pregnancy and risk for birth defects: findings from the National Birth Defects Prevention Study
Obstet Gynecol. 2010;115(1):109-115.
Feldkamp ML, Meyer RE, Krikov S, Botto LD.
[Read Summary]
Maternal use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), and muscular ventricular septal defects
Birth Defects Res A Clin Mol Teratol. 2004;70(3):107-113.
Cleves MA, Savell Jr VH., Raj S, Zhao W, Correa A, Werler MM, Hobbs CA.
[Read Summary]
Other Types of Medications
Maternal medication and herbal use and risk for hypospadias: data from the National Birth Defects Prevention Study, 1997-2007.
Pharmacoepidemiol Drug Saf. 2013;22(7):783-793.
Lind JN, Tinker SC, Broussard CS, Reefhuis J, Carmichael SL, Honein MA, Olney RS, Parker SE, Werler MM; National Birth Defects Prevention Study.
[Read Summary]
Nitrosatable drug exposure during early pregnancy and neural tube defects in offspring
Am J Epidemiol. 2011;174(11):1286-1295.
Brender JD, Werler MM, Kelley KE, Vuong AM, Shinde MU, Zheng Q, Huber Jr JC, Sharkey JR, Griesenbeck JS, Romitti PA, Langlois PH, Suarez L, Canfield MA and the National Birth Defects Prevention Study.
[Read Summary]
Prevalence and patterns of nitrosatable drug use among U.S. women during early pregnancy
Birth Defects Res A Clin Mol Teratol. 2011;91(4):258-264.
Brender JD, Kelley KE, Werler MM, Langlois PH, Suarez L, Canfield MA; National Birth Defects Prevention Study.
[Read Summary]
Weight Loss and Herbal Products
Herbal use before and during pregnancy
Am J Obstet Gynecol. 2010;202(5):443.e1-6.
Broussard CS, Louik CA, Honein MA, Mitchell AA, and the National Birth Defects Prevention Study.
[Read Summary]
Periconceptional use of weight loss products including ephedra and the association with birth defects
Birth Defects Res A Clin Mol Teratol. 2008;82(8):553-562.
Bitsko R, Reefhuis J, Louik C, Werler MM, Feldkamp ML, Waller K, Frias J, Honein MA,and the National Birth Defects Prevention Study.
[Read Summary]
Disease Treatment
Maternal exposure to methotrexate and birth defects: A population-based study
Am J Med Genet A. 2014;164(9):2212-6.
Dawson AL, Riehle-Colarusso T, Reefhuis J, Arena JF; National Birth Defects Prevention Study.
[Read Summary]
Use of topiramate in pregnancy and risk of oral clefts.
Am J Obstet Gynecol 2012;207(5):405.e1-7
Margulis AV, Mitchell AA, Gilboa SM, Werler MM, Mittleman MA, Glynn RJ, & National Birth Defects Prevention Study.
[Read Summary]
Maternal asthma medication use and the risk of selected birth defects
Pediatrics. 2012;129(2):e317-324.
Lin S, Munsie JP, Herdt-Losavio ML, Druschel CM, Campbell K, Browne ML, Romitti PA, Olney RS, Bell EM; National Birth Defects Prevention Study.
[Read Summary] [Read Key Findings]
Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects
Birth Defects Res A Clin Mol Teratol. 2012;94(1):22-30.
Anderka M, Mitchell AA, Louik C, Werler MM, Hernandez-Diaz S, Rasmussen SA, National Birth Defects Prevention Study.
[Read Summary]
Use of antiepileptic medications in pregnancy in relation to risks of birth defects
Ann Epidemiol. 2011;21(11):842-850.
Werler MM, Ahrens KA, Bosco JL, Mitchell AA, Anderka MT, Gilboa SM, Holmes LB; The National Birth Defects Prevention Study.
[Read Summary]
Maternal bronchodilator use and the risk of orofacial clefts
Hum Reprod. 2011;26(11):3147-3154.
Munsie JW, Lin S, Browne ML, Campbell KA, Caton AR, Bell EM, Rasmussen SA, Romitti PA, Druschel CM and the National Birth Defects Prevention Study.
[Read Summary]
Influencing clinical practice regarding the use of antiepileptic medications during pregnancy: modeling the potential impact on the prevalences of spina bifida and cleft palate in the United States
Am J Med Genet C Semin Med Genet. 2011;157(3):234-246
Gilboa SM, Broussard CS, Devine OJ, Duwe KN, Flak AL, Boulet SL, Moore CA, Werler MM, Honein MA.
[Read Summary] [Read Key Findings]
Maternal corticosteroid use and hypospadias
J Pediatr. 2009;155(1):39-44.
Carmichael SL, Ma C, Werler MM, Olney RS, Shaw GM, and the National Birth Defects Prevention Study.
[Read Summary]
Maternal asthma, asthma medication use, and the risk of congenital heart defects
Birth Defects Res A Clin Mol Teratol. 2009;85(2):161-168.
Lin S, Herdt-Losavio M, Gensburg L, Marshall E, Druschel C, and the National Birth Defects Prevention Study.
[Read Summary]
Maternal thyroid disease, thyroid medication use and selected birth defects in the National Birth Defects Prevention Study
Birth Defects Res A Clin Mol Teratol. 2009;85(7):621-628.
Browne ML, Rasmussen SA, Hoyt AT, Waller DK, Druschel CM, Caton AR, Canfield MA, Lin AE, Carmichael SL, Romitti PA, and the National Birth Defects Prevention Study.
[Read Summary]
Antihypertensive medication use during pregnancy and the risk of cardiovascular malformations
Hypertension. 2009;54(1):63-70.
Caton, AR, Bell EM, Druschel CM, Werler MM, Lin AE, Browne ML, McNutt LA, Romitti PA, Mitchell AA, Olney RS, Correa A and the National Birth Defects Prevention Study.
[Read Article]
Reviewing the evidence for mycophenolate mofetil as a new teratogen: case report and review of the literature
Am J Med Genet A. 2009;149A(6):1241-8.
Anderka MT, Lin AE, Abuelo DN, Mitchell AA, Rasmussen SA.
[Read Summary]
Maternal Exposure to Statins and Risk for Birth Defects: A Case-Series Approach (research letter)
Am J Med Genet A. 2008;146A(20):2701-2705.
Petersen EE, Mitchell AA, Carey JC, Werler MM, Louik C, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read Letter]
Maternal hypertension, antihypertensive medication use and the risk of severe hypospadias
Birth Defects Res A Clin Mol Teratol. 2008;82(1):34-40.
Caton AR, Bell EM, Druschel CM, Werler MM, Mitchell AA, Browne ML, McNutt LA, Romitti PA, Olney RS, Correa A, and the National Birth Defects Prevention Study.
[Read Summary]
Maternal asthma medication use and the risk of gastroschisis
Am J Epidemiol. 2008;168(1):73-79.
Lin S, Munsie JP, Herdt-Losavio ML, Bell EM, Druschel C, Romitti PA, Olney RS, and the National Birth Defects Prevention Study.
[Read Article]
Maternal corticosteroid use and orofacial clefts
Am J Obstet Gynecol. 2007 Dec;197(6):585.e1-7; discussion 683-4, e1-7.
Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, and Lammer EJ for the National Birth Defects Prevention Study.
[Read Summary]
Subfertility, Infertility, and Birth Control
Use of clomiphene citrate and birth defects, National Birth Defects Prevention Study, 1997–2005
Hum Reprod. 2010;doi: 10.1093/humrep/deq313.
Reefhuis J, Honein MA, Schieve LA, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read Key Findings]
Epidemiology of fertility treatment use among U.S. women with liveborn infants, 1997–2004
J Womens Health (Larchmt). 2010 Mar;19(3):407-416.
Duwe KN, Reefhuis J, Honein MA, Schieve LA, Rasmussen SA, and the National Birth Defects Prevention Study.
[Read Summary]
Use of oral contraceptives in pregnancy and major structural birth defects in offspring
Epidemiology. 2010;21(2):232-239.
Waller DK, Lockwood GT, Gallaway MS, Canfield MA, Scheuerle A, Hernandez-Diaz S, Louik C, Correa A, and the National Birth Defects Prevention Study.
[Read Summary]
The association between use of spermicides or male condoms and major structural birth defects
Contraception. 2009;80(5):422-429.
Gallaway MS, Waller DK, Canfield MA, Scheuerle A and the National Birth Defects Prevention Study.
[Read Summary]
Infections
Association between Antibiotic Use among Pregnant Women with Urinary Tract Infections in the First Trimester and Birth Defects, National Birth Defects Prevention Study 1997-2011.
Birth Defects Res A Clin Mol Teratol. 2016 Nov; 106(11): 940-949.
Ailes EC, Gilboa SM, Gill SK, Crider KS, Berry RJ, Carter TC, Hobbs CA, Interrante JD, Reefhuis J.
[Read Article]
Safety of influenza vaccination during pregnancy: A review of subsequent maternal obstetric events and findings from two recent cohort studies
Vaccine. 2014;32(26):3122-3127.
Naleway AL, Irving SA, Henninger ML, Li DK, Shifflett P, Ball S, Williams JL, Cragan J, Gee J, Thompson MG; for the Vaccine Safety Datalink and Pregnancy and Influenza Project.
[Read Summary]
Balancing competing risks: perinatal exposure to macrolides increases the risk of infantile hypertrophic pyloric stenosis
Evid Based Med. 2014 Aug 13. [Epub ahead of print]
Honein MA, Cragan JD.
[Read Summary]
Antibacterial medication use during pregnancy and risk of birth defects, National Birth Defects Prevention Study
Arch Pediatr Adolesc Med. 2009;163(11):978-985.
Crider KS, Cleves MA, Reefhuis J, Berry RJ, Hobbs CA, Hu DJ and the National Birth Defects Prevention Study.
[Read Article]
Antifungal drugs and the risk of selected birth defects
Am J Obstet Gynecol. 2008;198(2):191.e1-7.
Carter TC, Druschel CM, Romitti PA, Olney R, Werler M, Mitchell A and the National Birth Defects Prevention Study.
[Read Summary]
Over-the-Counter
The Safety or Risk of Antihistamine Use in Pregnancy: Reassuring Data Are Helpful but Not Sufficient
J Allergy Clin Immunol Pract.2013;1:675-6.
Honein MA and Moore CA.
[Read Summary]
Use of antihistamine medications during early pregnancy and isolated major malformations
Birth Defects Res A Clin Mol Teratol. 2009;85(2):137-150
Gilboa SM, Strickland MJ, Olshan AF, Werler MW, Correa A, and the National Birth Defects Prevention Study.
[Read Summary]
Physician Knowledge and Management
Obstetrician-gynaecologist knowledge of and access to information about the risks of medication use during pregnancy
T J Matern Fetal Neonatal Med. 2010;23(10):1143-1150.
Morgan MA, Cragan JD, Goldenberg RL, Rasmussen SA, Schulkin J.
[Read Article]
Management of prescription and non-prescription drug use during pregnancy
J Matern Fetal Neonatal Med. 2010;23(8):813-819.
Morgan MA, Cragan JD, Goldenberg RL, Rasmussen SA, Schulkin J.
[Read Article]
Maternal Behavior
Safe lists for medications in pregnancy: inadequate evidence base and inconsistent guidance from web-based information, 2011.
Pharmacoepidemiol Drug Saf. 2013;22(3):324-328.
Peters SL, Lind JN, Humphrey JR, Friedman JM, Honein MA, Tassinari MS, Moore CA, Mathis LL, Broussard CS.
[Read Summary]
Prescription medication borrowing and sharing among women of reproductive age
J Womens Health (Larchmt). 2008;17(7):1073-1080.
Petersen EE, Rasmussen SA, Daniel KL, Yazdy MM & Honein MA.
[Read Summary]
Can we ensure the safe use of known human teratogens? The iPLEDGE test case.
Drug Saf. 2007;30(1):5-15.
Honein MA, Lindstrom J, Kweder S.
[Read Summary]
Guidelines and Recommendations
*The following article summarizes a 2013 expert meeting held by CDC to discuss best methods for evaluating the safety of medications used to manage health conditions during pregnancy.
Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention–convened meeting
Am J Obstet Gynecol. 2014 May 29; e-published ahead of print.
Broussard CS, Frey MT, Hernandez-Diaz S, Greene MF, Chambers CD, Sahin L, Collins Sharp BA, Honein MA.
[Read Summary]
* The following guidelines and recommendations were drafted by scientists from CDC or other agencies or organizations.
ACOG Committee Opinion No. 524: Opioid Abuse, Dependence, and Addiction in Pregnancy
Obstet Gynecol 2012 May; 119:1070-1076.
[Read Summary]
ACOG Committee Opinion No. 494: Sulfonamides, Nitrofurantoin, and Risk of Birth Defects
Obstet Gynecol. 2011 Jun;117(6):1484-1485.
American College of Obstetricians and Gynecologists Committee on Obstetric Practice.
[Read Summary]
Pregnant Women & Influenza (Flu)
[Read Recommendation]
2010-2011 Influenza Antiviral Medications: Summary for Clinicians
[Read Recommendation]
Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment–Update 2004
These NIH recommendations, updated during 2004, provide guidance on medication treatment for pregnant women with asthma.
[Read Recommendation]
Updated Recommendations for Antimicrobial Prophylaxis Among Asymptomatic Pregnant Women After Exposure to Bacillus anthracis
These recommendations, published in the Morbidity and Mortality Weekly Report, are used to provide guidance for physicians in choosing the best antibiotic for their patient.
[Read Recommendation]
Smallpox Vaccination Information for Women Who are Pregnant or Breastfeeding
[Read Guidelines]
U.S. Public Health Service Task Force Recommendations for Use–of Antiretroviral Drugs in Pregnant HIV-1–Infected Women for Maternal Health and Interventions To Reduce Perinatal HIV-1 Transmission in the United States
[Read Recommendation] Top of Page
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Search a database of articles that have been published by CDC authors within the National Center on Birth Defects and Developmental Disabilities from 1990 to present.
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