Selected References:

• Bourg M, et al. 2020. Fertility and sexuality of women with inflammatory arthritis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 251:199-205. 
• Giovannopoulou E, et al. 2017. Ankylosing Spondylitis and Pregnancy: A Literature Review. Curr Rheumatol Rev. 13(3):162-169. 
• Girbash E, et al. 2023. Maternal Interleukin-17 and disease activity influence pregnancy outcomes in women with psoriatic arthritis. BMC Pregnancy Childbirth. 23(1):35. 
• Gordon D, Beastall GH, Thomson JA, et al. 1986 Androgenic status and sexual function in males with rheumatoid arthritis and ankylosing spondylitis. Q J Med; 60(231): 671–679.  
• Jakobsson GL, et al. 2016. Pregnancy outcomes in patients with ankylosing spondylitis: a nationwide register study. Ann Rheum Dis. 75(10):1838-42. 
• Lee JS, et all. 2020. Reasons for the High Cesarean Delivery Rate among Women with Ankylosing Spondylitis: Using the Korean National Health Insurance Database. The Journal of Rheumatology, 47(5) 668-673. 
• Lui NL, et al. 2011. Effect of pregnancy on ankylosing spondylitis: a case-control study. J Rheumatol 38(11):2442-4. 
• Maguire S, et al. 2020. Pregnancy in axial spondyloarthropathy–A systematic review & meta-analysis. Semin Arthritis Rheum; 50(6):1269-1279. 
• Maguire S, et al. 2022. What to expect when women with axial spondyloarthritis are expecting: Prevalence of complications of pregnancies in women with axial spondyloarthritis. Semin Arthritis Rheum; 54:151993. 
• Menekse Beser D, et al. 2023. Assessment of fetal pulmonary artery Doppler indices in pregnant women with rheumatoid arthritis and ankylosing spondylitis. J Clin Ultrasound. 51(6):983-991. 
• Mokbel A, et al. 2021. Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review. Clin Rheumatol; 40(9):3465-3480.   
• Mørk S, et al. 2021. Spondyloarthritis and outcomes in pregnancy and labor–A nationwide register-based cohort study. Arthritis Care Res, 73(2), 282-288. 
• Ostensen M. 1992. The effect of pregnancy on ankylosing spondylitis, psoriatic arthritis, and juvenile rheumatoid arthritis. Am J Reprod Immunol. 28(3-4):235-7. 
• Ostensen M & Husby G. 1989. Ankylosing spondylitis and pregnancy. Rheum Dis Clin North Am.  15(2):241-54. 
• Ostensen M & Ostensen H. 1998. Ankylosing spondylitis–the female aspect. J Rheumatol. 25(1):120-4. 
• Ostensen M, et al. 2004. A prospective study of pregnant patients with rheumatoid arthritis and ankylosing spondylitis using validated clinical instruments. Ann Rheum Dis. 63(10):1212-7.   
• Ramonda R, Foresta C, Ortolan A, et al. 2014. Influence of tumor necrosis factor α inhibitors on testicular function and semen in spondyloarthritis patients. Fertil Steril. 101(2): 359–365. 
• Saougou I1, Markatseli TE, Papagoras C, et al. 2013. Fertility in male patients with seronegative spondyloarthropathies treated with infliximab. Joint Bone Spine; 80(1): 34–37. 
• Scriffignano S, et al. 2024. Male Fertility in Spondyloarthritis: from Clinical Issues to Cytokines Milieu. A Narrative Review. Curr Rheumatol Rep. doi: 10.1007/s11926-024-01153-w.  
• Smith CJF, et al. 2020. Birth Outcomes and Disease Activity During Pregnancy in a Prospective Cohort of Women With Psoriatic Arthritis and Ankylosing Spondylitis. Arthritis Care Res, 72:1029-1037. 
• Unal C, et al. 2020. Retrospective evaluation of pregnancies with ankylosing spondylitis in a tertiary center in Turkey. Int J Rheum Dis. 23:101-105. 
• Uyaroglu OA, Seyhoglu E, Erden A, et al. 2020. Pregnancy outcomes in partners of male ankylosing spondylitis patients treated with anti-tumour necrosis factor-α biologics: real-life results from a single-centre cross-sectional study. Rheumatol Int.;40(9):1501-1507.  
• Yildirim M, et al. 2023. Assessment of fetal thymus size in pregnant women with rheumatic diseases: A case-control study. J Clin Ultrasound. 51(8): 1342-1347. 

Selected References:

• Deepaklal MC, et al. 2015. Insulin aspart in patients with gestational diabetes mellitus and pregestational diabetes mellitus. Indian J Endocrinol Metab; 19(5): 658–662. 
• Hod M, et al. 2008. Fetal and perinatal outcomes in type 1 diabetes pregnancy: a randomized study comparing insulin aspart with human insulin in 322 subjects. Am J Obstet Gynecol’ 198(2)186.e1-7. 
• Matheisen ER, et al. 2007. Maternal glycaemic control and hypoglycaemia in Type 1 diabetes pregnancy: a randomized trial of insulin aspart vs. human insulin in 322 pregnant women. Diabetes Care; 30(4):771-776. 
• Mathiesen ER, et al. 2008. Insulin Aspart in Diabetic Pregnancy: State of the Art. Women’s Health 4(2):119-124.  
• Mathiesen ER, et al; EVOLVE study group. 2024. A comparison of the safety and effectiveness of insulin aspart with other bolus insulins in women with pre-existing Type 1 diabetes during pregnancy: A post hoc analysis of a prospective cohort study. Diabet Med; 41(10):e15411.  
• Insulin Aspart Product Label. 2023. National Institute of Health DailyMed database. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bee5b358-c863-420b-be73-ced2e920c499. Accessed 3/2026.  
• Pettitt DJ, et al. 2007. Efficacy, safety and lack of immunogenicity of insulin aspart compared with regular human insulin for women with gestational diabetes mellitus. Diabet Med; 24(10): 1129–1135. 
• Shehadeh N, et al. 2001. Importance of insulin content in infant diet: suggestion for a new infant formula. Acta Paediatr; 90(1):93-95. 
• Shehadeh N, et al. 2001. Insulin in human milk and the prevention of type 1 diabetes. Pediatr Diabetes; 2(4):175-177. 
• Whitmore TJ, et al. 2012. Analysis of Insulin in Human Breast Milk in Mothers with Type 1 and Type 2 Diabetes Mellitus. Int J Endocrinol. vol. 2012: Article ID 296368.  

Selected References:  

• Abdellatif M, et al. 2019. Association between exposure to macrolides and the development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Eur J Pediatr. 178:301–314.  
• Antonucci R, et al. 2022. Use of Azithromycin in Pregnancy: More Doubts than Certainties. Clinical drug invest. 42(11): 921–935.  
• Bakheit, AH, et al. 2014. Azithromycin. Profiles of Drug Substn, Excip, and Rel Methodol. 39:1-40. 
• Bérard A et al. 2015. Use of macrolides during pregnancy and the risk of birth defects: a population-based study. Pharmacoepidemiol Drug Saf 24(12):1241–1248. 
• Cooper WO, et al. 2002. Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis. Obstet Gynecol; 100:101–106.  
• Cooper WO, et al. 2009. Antibiotics potentially used in response to bioterrorism and the risk of major congenital malformations. Paediatr Perinat Epidemiol. 23(1):18-28.  
• Damkier P, et al. 2019. In utero exposure to antibiotics and risk of congenital malformations: a population-based study. Am J Obstet Gynecol 221(6):648.e1–648.e15. 
• Fan H, et al. 2020. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UKL Population based cohort study. BMJ 368:m331.  
• Figueroa-Romero A, et al. 2022. Drugs for intermittent preventive treatment of malaria in pregnancy: current knowledge and way forward. Trop. Med. Infect. Dis. 8(7): 152. 
• Goldstein LH, et al. 2009. The safety of macrolides during lactation. Breastfeed Med, 4(4):197-200.  
• Heikkinen T., et al. 2005. The transplacental transfer of the macrolide antibiotics erythromycin, roxithromycin and azithromycin. BJOG: An Intern Jour of Obstet and Gynaecol. 107(6):770-775. 
• Hume-Nixon M, et al. 2021. A systematic review and meta-analysis of the effect of administration of azithromycin during pregnancy on perinatal and neonatal outcomes. EClinicalMedicine 40:101123.  
• Leke, AZ, et al. 2021. Macrolide and lincosamide antibiotic exposure in the first trimester of pregnancy and risk of congenital anomaly: A European case-control study. Reprod Toxicol 100:101–108. 
• Lund M, et al. 2014. Use of macrolides in mother and child and risk of infantile hypertrophic pyloric stenosis: nationwide cohort study. BMJ. 348:g1908.  
• Mårdh PA. 2002. Influence of infection with chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring. Best Pract and Research Clin Obstet and Gynaec. 16(6): 847-864. 
• Muanda FT, et al. 2017. Use of antibiotics during pregnancy and risk of spontaneous abortion. CMAJ. 189(17):625-633. 
• Pfizer Labs. 2021. Zithromax (azithromycin) label. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/050670s036,050710s051,050711s050,050784s037lbl.pdf. Accessed 4 Nov 2025.  
• Rahangdale L, et al. 2006. An observational cohort study of Chlamydia trachomatis treatment in pregnancy. Sex Transm Dis. 33(2):106-110. 
• Sandman Z., Iqbal OA. 2024. Azithromycin. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557766/. Accessed 4 Nov 2025.  
• Sarkar M, et al. 2006. Pregnancy outcome following gestational exposure to azithromycin. BMC Pregnancy Childbirth. 6:18.  
• Sørensen HT, et al. 2003. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 35(2):104-106.  
• Sutton A, et al. 2014. Azithromycin accumulates in breast milk following a single dose for cesarean prophylaxis. AJOG. 210(1):S235.  
• Tellem R, et al. 2005. Pregnancy outcome after gestational exposure to the new macrolides: a prospective controlled cohort study. Reprod Toxicol.;20(3):484-485.  
• U.S. Centers for Disease Control and prevention. 2021. Chlamydia Infections – STI Treatment Guidelines. Available at: https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm. Accessed 4 Nov 2025. 
• Wilton LV, et al. 1998. The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. Br J Obstet Gynaecol. 105(8): 882–889. 

Selected References:

• American Academy of Pediatrics Committee on Genetics. 2008. Maternal phenylketonuria. Pediatrics 122:445–449. 
• American College of Obstetricians and Gynecologists Committee on Genetics. 2020. Management of women with phenylalanine hydroxylase deficiency (phenylketonuria). Obstet Gynec, 135(4):e167-e170.  
• Bier C, et al. 2024. Outcomes in 14 live births resulting from Pegvaliase-treated pregnancies in PKU-affected females. Mol Genet Metab, 141(3):108152. 
• BioMarin Pharmaceutical Inc. Palynziq medication label. Available at: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=6dba844a-db02-44f8-8593-ce497ed9406c&type=display. Accessed 27 October 2025.  
• Cunningham A, et al. 2023. Nutrition management of PKU with pegvaliase therapy: Update of the web-based PKU nutrition management guideline recommendations. Orphanet J Rare Dis, 18:155. 
• Fisch RO, et al. 1981 Semen studies on phenylketonurics. Biochem Med, 26(3):427434. Kopesky JJ, et al. 2024. Successful outcomes with continued pegvaliase-pqpz treatment throughout pregnancy and lactation in a PKU patient. Mol Genet Metab, 141:18. 
• Levy HL, Waisbren SE. 1983. Effects of untreated maternal phenyketonura and hyperphenylalaninemia on the fetus. N Engl J Med, 309:1269-1274.  
• Rohr F, et al. 2020. Discontinuation of pegvaliase therapy during maternal PKU pregnancy and postnatal breastfeeding: A case report. Mol Genet Metab Rep, 22:100555.  
• Rohr F, et al. 2022. Reinstitution of pegvaliase therapy during lactation. Mol Genet Metab Rep, 33:100938.  
• Teissier R, et al. 2012. Maternal phenylketonuria: low phenylalaninemia might increase the risk of intra uterine growth retardation. J Inherit Metab Dis, 35(6):993-999.  
• U.S. Food and Drug Administration Center for Drug Evaluation and Research. Active Risk Identification and Assessment (ARIA) Sufficiency Memo for Pregnancy Safety Concerns. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2018/761079Orig1s000OtherR.pdf. Accessed 27 October 2025. 
• Waisbren SE, et al. 2015. Maternal phenylketonuria: long-term outcomes in offspring and post-pregnancy maternal characteristics. JIMD Rep, 21:23-33. 

Selected References:  

• Ahmad MK, et al. 2010. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertil Steril, 94(3), 989–996. 
• Ali H, et al. 2017. Effect of maternal antenatal and newborn supplementation with vitamin A on cognitive development of school-aged children in rural Bangladesh: a follow-up of a placebo-controlled, randomized trial. Am J Clin Nutr, 106(1), 77–87. 
• American College of Obstetricians and Gynecologists (ACOG). (n.d.). Nutrition during pregnancy. ACOG. Retrieved May 4, 2025. 
• Beurskens LW, et al. 2013. Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring. Birth Defects Res A Clin Mol Teratol, 97(1), 60–66. 
• Botto LD, et al. 2001. Vitamin A and cardiac outflow tract defects. Epidemiology, 12, 491–496. 
• Chameli G & Mukherjee KL. 1988. Relationship between maternal serum vitamin A and vitamin A status of the corresponding fetuses. J Trop Pediatr, 34(6), 313–315. 
• Christian P, et al. 2013. Effects of vitamin A and beta-carotene supplementation on birth size and length of gestation in rural Bangladesh: a cluster-randomized trial. Am J Clin Nutr, 97(1), 188–194. 
• Clagett-Dame M & Knutson D. 2011. Vitamin A in reproduction and development. Nutrients, 3(4), 385–428. 
• Darling AM, et al. 2017. Vitamin A and zinc supplementation among pregnant women to prevent placental malaria: a randomized, double-blind, placebo-controlled trial in Tanzania. Am J Trop Med Hyg, 96(4), 826–834. 
• Fonseca BM, et al. 2023. Retinoic acid (all-trans) presents antioxidant properties within human ovary and reduces progesterone production by human granulosa cells. Syst Biol Reprod Med, 69(2), 129–141. 
• Hamdy AM, et al. 2013. Maternal vitamin A deficiency during pregnancy and its relation with maternal and neonatal hemoglobin concentrations among poor Egyptian families. ISRN Pediatr, 652148.  
• Huang Y & Zheng S. 2011. The effect of vitamin A deficiency during pregnancy on anorectal malformations. J Pediatr Surg, 46(7), 1400–1405. 
• Institute of Medicine (US) Panel on Micronutrients. 2001. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington (DC): National Academies Press (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK222318/. 
• Ishikawa Y, et al. 2016. Prenatal vitamin A supplementation associated with adverse child behavior at 3 years in a prospective birth cohort in Japan. Pediatr Int, 58(9), 855–861. 
• Mastroiacovo P, et al. 1999. High vitamin A intake in early pregnancy and major malformations: a multicenter prospective controlled study. Teratology, 59(1), 7–11. 
• Mills JL, et al. 1997. Vitamin A and birth defects. Am J Obstet Gynecol, 177(1), 31–36. 
• Panth M, et al. 1990. Effect of vitamin A supplementation on haemoglobin and vitamin A levels during pregnancy. Br J Nutr, 64(2), 351–358. 
• Pitchik HO, et al. 2018. Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, Tanzania. Child Care Health Dev, 44(6), 841–849.  
• Sakurai T, et al. 2005. Fat-soluble and water-soluble vitamin contents of breast milk from Japanese women. J Nutr Sci Vitaminol, 51(4), 239–247. 
• Shaw GM, et al. 1997. Periconceptional intake of vitamin A among women and risk of neural tube defect-affected pregnancies. Teratology, 55, 132–133.