Safety of medications during pregnancy and breastfeeding

The use of medications during pregnancy has become a concern since the thalidomide tragedy. However, although avoiding medications during pregnancy and breastfeeding may be desirable, it is often not possible. Medication use during pregnancy and postpartum is often necessary and unavoidable in chronic conditions such as asthma, diabetes mellitus, hypertension, epilepsy or depression. Women can also develop acute illnesses or pregnancy-induced complications that necessitate drug therapy. In addition, because approximately 50% of pregnancies are unplanned, women are frequently exposed to therapeutic drugs not necessarily intended to be used during pregnancy. Epidemiological studies have determined that two-thirds of all pregnant women use at least one prescription drug during pregnancy [1, 2]. However, in a review conducted in 2001 it was estimated that more than 90% of the drugs approved by the FDA between 1980 and 2000 had insufficient human pregnancy data to determine whether the benefits of treatment exceeded the risk to the embryo and/or fetus [3]. This reality highlights the growing need for more and better data regarding medication use during pregnancy and breastfeeding.