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Medication during pregnancy: 10 principles to avoid adverse effects in the unborn child

In the special issue of French medical journal Prescrire: for a woman who is pregnant, or who might be or become pregnant, taking medications can expose the unborn child to harmful effects, often poorly known, and sometimes extremely serious and irreversible. A few principles can be useful in avoiding them.

Some principles to avoid adverse effects to the unborn child from medications taken during pregnancy:

  • use caution when it comes to any woman who is pregnant, who might be pregnant, or who might soon become pregnant;
  • know the patently toxic drugs in order to avoid these drugs, or else to provide for effective contraception;
  • be aware that there is great uncertainty and lack of knowledge when it comes to most drugs;
  • avoid any treatments whose efficacy is uncertain;
  • take both the mother and the child into account when evaluating a treatment’s harm-benefit balance;
  • take maximum precautions during the first trimester of pregnancy: it is best to use a tried and tested drug, at minimal doses, and for the shortest time possible;
  • late in the pregnancy, be aware of the drug’s known effects outside of pregnancy, and take them into account;
  • keep in mind that the long-term effects on the development of the unborn child are unknown;
  • inform patients about the dangers of medications taken during pregnancy;  
  • organise monitoring and management of any adverse effects that can be anticipated in children.

©Prescrire 1 August 2013

Source: "Femmes enceintes et médicaments" Rev Prescrire 2013 ; 33 (358).
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