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Medications in Pregnancy and Lactation: Part 2. Drugs With Minimal or Unknown Human Teratogenic Effect

Buhimschi, Catalin S. MD; Weiner, Carl P. MD, MBA

doi: 10.1097/AOG.0b013e31818d686c
Clinical Expert Series
Expert Discussion

This is the second of a two-part series on the use of medication during pregnancy and lactation. Pregnancy risk factors together with an increased incidence of chronic diseases and the rise in mean maternal age predict an increase in medication use during gestation. However, as highlighted in the first installment of this series, relatively few medications have specifically been tested for safety and efficacy during pregnancy, and, therefore, responses to those inquiries can be uninformed and inaccurate. Whereas the first installment provided new insight into the nature of medications with known human teratogenic effects, this part concentrates on drugs with minimal or no known human teratogenic effect. It is important that clinicians become familiar with all of the aspects of the drugs they prescribe, in addition to the controversies surrounding them, through consultation with maternal–fetal medicine specialists and through references and Web sites providing up-to-date information in an effort to promote safer prescribing practices.

Comprehensive information on currently prescribed drugs classified as nonteratogenic or with unknown teratogenicity is essential for physicians recommending drug treatment for pregnant and breast-feeding women. Supplemental Digital Content is available in the text.

From the 1Department of Obstetrics, Gynecology and Reproductive Science, Yale University School of Medicine, New Haven, Connecticut; and 2Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, Kansas.

Continuing medical education is available online at

The authors thank Kelly Horvath, MA, for her assistance with the writing and editing of the manuscript.

Continuing medical education is available online at

Corresponding author: Catalin S. Buhimschi, MD, Director, Perinatal Research, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, LLCI 804, New Haven, CT 06520; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.