Selected References:

• Bokun V, et al. 2019. Respiratory Syncytial Virus Exhibits Differential Tropism for Distinct Human Placental Cell Types with Hofbauer Cells Acting as a Permissive Reservoir for Infection. PloS One; 14(12):e0225767. 
• Centers for Disease Control and Prevention (CDC). 08/2023. Respiratory Syncytial Virus Infection (RSV) web page: https://www.cdc.gov/rsv/index.html [Accessed 10/2025]. 
• Centers for Disease Control and Prevention (CDC). 08/2024. RSV Vaccine Guidance for Pregnant Women. https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/pregnant-people.html. [Accessed 10/205]. 
• Chu HY, et al. 2016. Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy. PLoS One. 2016 Mar 31;11(3):e0152015.  
• Chiba Y, et al. 1987. Effect of breast feeding on responses of systemic interferon and virus-specific lymphocyte transformation in infants with respiratory syncytial virus infection. J Med Virol; 21(1):7-14. 
• Downham MA, et al. 1976. Breast-feeding protects against respiratory syncytial virus infections. Br Med J; 2:274-6. 
• Ferolla FM, et al. 2013. Macronutrients during pregnancy and life-threatening respiratory syncytial virus infections in children. Am J Respir Crit Care Med; 187(9):983-90.  
• Fonceca AM, et al. 2017. Infective Respiratory Syncytial Virus is Present in Human Cord Blood Samples and Most Prevalent During Winter Months. PloS One; 12(4):e0173738.  
• Galanti M, et al. 2019. Rates of asymptomatic respiratory virus infection across age groups. Epidemiol Infect; 147:e176.  
• Hause A, et al. 2021. Adverse Outcomes in Pregnant Women Hospitalized with Respiratory Syncytial Virus Infection: A Case Series, Clinical Infectious Diseases: 72(1):138–140. 
• Irvine LM, et al. 1990. Elevated viral antibody titres in spontaneous abortion. FEMS Microbiol Immunol; 2(1):23-7.  
• Kenmoe S, et al; PROMISE Investigators. 2024. Burden of Respiratory Syncytial Virus–Associated Acute Respiratory Infections During Pregnancy. The Journal of Infectious Diseases 229(Suppl 1): S51–S60. 
• Manti S, et al. 2017. Detection of Respiratory Syncytial Virus (RSV) at Birth in a Newborn with Respiratory Distress. Pediatr Pulmonol; 52(10):e81–4.  
• Manti S, et al. 2020. Respiratory syncytial virus seropositivity at birth is associated with adverse neonatal respiratory outcomes. Pediatr Pulmonol; 55(11):3074-3079.  
• Mineva G & Philip R. 2022. Impact of Breastfeeding on the Incidence and Severity of RSV Bronchiolitis in Infants: Systematic Review. Pediatrics; 149 (1 Meeting Abstracts): 280. 
• Nandapalan N, et al. 1987. Mammary immunity of mothers of infants with respiratory syncytial virus infection. J Med Virol; 22:277-87. 
• Okamoto Y, et al. 1989. Effect of breast feeding on the development of anti-idiotype antibody response to F glycoprotein of respiratory syncytial virus in infant mice after post-partum maternal immunization. J Immunol; 142:2507-12. 
• Patel SM, et al. 2019. Placental transfer of respiratory syncytial virus antibody among HIVexposed, uninfected infants. Journal of the Pediatric Infectious Diseases Society. Pediatric Infect Dis Soc. 2020 Jul 13;9(3):349-356.  
• Piedimonte G, et al. 2013. Vertical transmission of respiratory syncytial virus modulates pre- and postnatal innervation and reactivity of rat airways. PLoS One; 8(4):e61309. 
• Regan AK, et al. 2018. Respiratory Syncytial Virus Hospitalization During Pregnancy in 4 High-Income Countries, 2010-2016. Clin Infect Dis. 67(12):1915–8. 
• Riccò M, et al. 2022. Respiratory Syncytial Virus in Pregnant Women: Systematic Review and Meta-Analysis. Women; 2(2):147-160. 
• Scott R, et al. 1985. Cellular reactivity to respiratory syncytial virus in human colostrum and breast milk. J Med Virol; 17(1):83-93.  
• Weinberg A, et al. 2018. Factors associated with lower respiratory tract infections in HIV-exposed uninfected infants. AIDS Research and Human Retroviruses. 34(6):527–535. 
• Wheeler SM, et al. 2015. Maternal Effects of Respiratory Syncytial Virus Infection during Pregnancy. Emerg Infect Dis; 21(11):1951-1955. 

Selected References:

• AAP Committee on Drugs. 2001. The transfer of drugs and other chemicals into human milk. Pediatrics 108:776-789.  
• Acar S, et al. 2019. Pregnancy outcomes following quinolone and fluoroquinolone exposure during pregnancy: A systematic review and meta-analysis. Reprod Toxicol, 85:65-74. 
• Berkovitch M, et al. 1994. Safety of the new quinolones in pregnancy. Obstet Gynecol, 84(4):535-538.  
• Boissiere-O’Neill T, et al. 2025. Exposure to Systemic Antimicrobials During Pregnancy and Risk of Miscarriage: A Population-Based Registry Study. BJOG. 
• Bomford JAL, et al. 1993. Ciprofloxacin use during pregnancy. Drugs, 45(S3): 461-462. 
• Cavusoglu I, et al. 2016. Evaluation of teratogenic effects of ciprofloxacin in pregnant women exposed due to urinary tract infections (abstract). Reprod Toxicol, 60:178. 
• Cover DL, Mueller BA. 1990. Ciprofloxacin penetration into human breast milk: a case report. DICP, 24:703-704.  
• 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. 
• Gardner D, et al. 1992. Simultaneous concentrations of ciprofloxacin in breast milk and in serum in mother and breast-fed infant. Clin Pharm, 11:352-354.  
• Kabeya CM, et al. 1995. Ciprofloxacin for multiresistant enteric fever in pregnancy. The Lancet, 346:307-308. 
• Leung D, et al. 1995. Treatment of typhoid in pregnancy. The Lancet, 346:648.  
• Loebstein R, et al. 1998. Pregnancy outcome following gestational exposure to fluoroquinolones: a multicenter prospective controlled study. Antimicrob Agents Chemother, 42(6):1336-1339.  
• Meaney-Delman D, et al. 2013 Prophylaxis and treatment of anthrax in pregnant women. Obstet Gynecol, 122(4):885-900.  
• Muanda FT, et al. 2017. Use of antibiotics during pregnancy and the risk of major congenital malformations: a population-based cohort study. Br J Clin Pharmacol; 83:2557–2571.  
• Nahum G, et al. 2006. Antibiotic use in pregnancy and lactation. Obstet Gynecol, 107(5):1120-1138. 
• Noergaard M, et al. 2022. Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study. BJOG, 129(9):1503-1511.  
• Padberg S, et al. 2014. Observational cohort study of pregnancy outcomes after first-trimester exposure to fluoroquinolones. Antimicrob Agents Chemother, 58(8):4392-4398. 
• Schaefer C, et al. 1996. Pregnancy outcome after prenatal quinolone exposure: evaluation of a case registry of the European Network of Teratology Information Services (ENTIS). Eur J Obstet Gynecol, 69:83-89.  
• Schluter G. 1989. Ciprofloxacin: toxicologic evaluation of additional safety data. The Am J Med, 87(5A):S37-S39. 
• Van Wattum JJ, et al. 2019. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol, 124(1):5-17. 
• Xiang DC, et al. 2024. Pregnancy-related adverse events and congenital disorders associated with fluoroquinolones: A real-world pharmacovigilance study of the FDA Adverse Event Reporting System (FAERS). Heliyon. 10(18):e37547.  
• Xiong W, et al. 2024. Association between maternal antibiotic exposure and emotional and behavioural problems in children at four years of age: A biomonitoring-based prospective study. Ecotoxicol Environ Saf. 284:116949.  
• Yefet E, et al. 2018. The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis.  

Selected References:

• Altuwaijri M. 2022. Evidence-based treatment recommendations for gastroesophageal reflux disease during pregnancy: A review. Medicine. 101(35).
• Anderka M, et al, and the National Birth Defects Prevention Study. 2012. Medications Used to Treat Nausea and Vomiting of Pregnancy and the Risk of Selected Birth Defects. Birth Defects Res (Part A); 94:22-30.
• Beinder E. 2007. Calcium-supplementation in pregnancy-is it a must?. Ther Umsch. 2007 May;64(5):243-7.
• Borkenhagen JF, et al. 2013. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion. Pediatr Neurol. 48(6):469-71.
• D’Souza R, et al. 2013. Calcium carbonate intoxication in pregnancy: the return of the milk-alkali syndrome. J Obstet Gynaecol Can. 35(11): 976–7.
• Fairney A, Weir AA. 1970. The effect of abnormal maternal plasma calcium levels on the offspring of rats. J Endocr 48:337-345.
• Hofmeyr GJ, et al. 2014. Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary. BJOG: 121(8): 951–957.
• Ito M, et al. 1994. Prevention of preeclampsia with calcium supplementation and vitamin D3 in an antenatal protocol. Int J Gynaecol Obstet 47(2):115- 120.
• Heinonen OP, et al. 1977 Birth Defects and Drugs in Pregnancy. Littleton, Mass.: John Wright-PSG, pp 444, 479, 498.
• Katz PO, et al. 2022. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 117(1):27-56.
• Kolnick L, et al. 2011. Hypercalcemia in pregnancy: a case of milk-alkali syndrome. J Gen Intern Med. 26(8):939-42.
• Lagarto A, et al. 2013. Prenatal effects of natural calcium supplement on Wistar rats during organogenesis period of pregnancy. Exp Toxicol Pathol. 65(1-2):49-53.
• Merialdi M, et al. 2003. Nutritional interventions during pregnancy for the prevention or treatment of impaired fetal growth: an overview of randomized controlled trials. J Nutr 133(5 Suppl 2):1626S-1631S.
• Morton A. 2002. Milk-alkali syndrome in pregnancy, associated with elevated levels of parathyroid hormone-related protein. Intern Med J 32: 492-494.
• National Institutes of Health Office of Dietary Supplements. 2022. Calcium Fact Sheet for Health Professionals. Available at: https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.
• Picolos MK, et al. 2004. Milk-alkali syndrome in pregnancy. Obstet Gynecol 104:1201-4.
• Thornton MD, et al. 2013. Neonatal seizures: soothing a burning topic. Pediatr Emerg Care. 29(10):1107-10.
• Trezevant MS, 2019. Hypercalcemia-induced pancreatitis in pregnancy following calcium carbonate ingestion. J Pharm Pract. 32(2):225–7.
• Robertson W. 2002. Calcium carbonate consumption during pregnancy: an unusual cause of neonatal hypocalcemia. Journal of child neurology. 17(11):853-55.
• Rodriguez H. 2018. Are You Getting Enough Calcium to Get Pregnant?. Natural Fertility Info: 1.
• Ulliam ME, Linas SL. 1988. The milk-alkali syndrome in pregnancy. Case report. Miner Electrolyte Metab 14:208-10

Selected References:   

• Allaert SE, et al. 2007. First trimester anesthesia exposure and fetal outcome. A review. Acta Anaesthesiol Belg, 58(2):119-123.  
• Allweiler SI, Kogan LR. 2013. Inhalation anesthetics and the reproductive risk associated with occupational exposure among women working in veterinary anesthesia. Vet Anaesth Analg, 40(3):285-289. 
• Anderson PO. 2021. General anesthesia while breastfeeding. Breastfeeding Medicine, 16(4):275-277.  
• Andropoulos DB, Greene MF. 2017. Anesthesia and developing brains – Implications of the FDA Warning. N Engl J Med, 376(10):905-907.  
• Beatriz L, et al. 2015. Anesthesia for non-obstetrical surgery during pregnancy. Gen Med Open Access; 3:1–4.  
• Bleeser T, et al. 2022. Neurodevelopmental outcomes after prenatal exposure to anaesthesia for maternal surgery: a propensity-score weighted bidirectional cohort study. Anaesthesia, 78:159–169. 
• Brodsky JB, et al. 1980. Surgery during pregnancy and fetal outcome. Am J Ob Gyn, 138(8):1165-1167. 
• Choi HN, et al. 2021. Evaluation of safety and foeto-maternal outcome following non-obstetric surgery in pregnancy: a retrospective single-site Australian study. ANZ J Surg, 91:627-632.  
• Cusimano MC, et al. 2023. Adverse fetal outcomes and maternal mortality following nonobstetric abdominopelvic surgery in pregnancy: a systematic review and meta-analysis. Ann Surg, 278:e147–e157. 
• Czeizel AE, et al. 1998. Reproductive outcome after exposure to surgery under anesthesia during pregnancy. Arch Gynecol Obstet, 261(4):193-199. 
• Dalal PG, et al. 2014. Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth, (4):359-371.  
• Duncan PG, et al. 1986. Fetal risk of anesthesia and surgery during pregnancy. Anesthesiology, 64:790-794.  
• Fisher SC, et al. 2020. Maternal surgery and anesthesia during pregnancy and risk of birth defects in the National Birth Defects Prevention Study, 1997-2011. Birth Defects Res, 112(2):162-174.  
• Gwanzura C, et al. 2023. Effect of anesthesia administration method on apgar scores of infants born to women undergoing elective cesarean section. BMC Anesthesiol. 23(1):142. 
• Haataja, A, et al. 2023. Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review. Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society, 112(3), 187–205. 
• Ing C, et al. 2021. Prenatal exposure to general anesthesia and childhood behavioral deficit. Anesth Analg. 133(3):595-605. 
• Jankowsky J, et al. 2023. Best Practices for the Care of Breastfeeding Patients Requiring Local or General Anesthesia. Nurs Womens Health. 27(3):231-236. 
• Knill-Jones RP, et al. 1975. Anaesthetic practice and pregnancy. Lancet, 2:807–809. 
• Mazze RI, Källén B. 1989. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol, 161(5):1178-1185. 
• Olutoye OA, et al. 2018. Food and Drug Administration warning on anesthesia and brain development: implications for obstetric and fetal surgery. Am J Obstet Gynecol, 218(1):98-102. 
• Robbins LS, et al. 2021. General anesthesia for cesarean delivery and childhood neurodevelopment and perinatal outcomes: a secondary analysis of a randomized controlled trial. Int J Obstet Anesth. 45:44-40. 
• Sanders RD, et al. 2013. Impact of anaesthetics and surgery on neurodevelopment: an update. Br J Anaesth, 110 Suppl 1:i53-72.  
• Smith BE. 1963. Fetal prognosis after anesthesia during gestation. Anesth Analg, 42;521-526. 
• Shnider SM, Webster, GM. 1965. Maternal and fetal hazards of surgery during pregnancy. Am J Obstet Gynecol, 92;891-900. 
• Sylvester GC, et al. 1994. First-trimester anesthesia exposure and the risk of central nervous system defects: a population-based case-control study. Am J Public Health, 84(11)1757-1760. 
• Tolcher MC, et al. 2018. Nonobstetric surgery during pregnancy. Obstet Gynecol 132:395–403.  
• Upadya M, Saneesh P. 2016. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth 60:234.   
• US FDA. FDA Drug Safety Communication. 4/27/17. FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. Update. FDA approves label changes for use of general anesthetic and sedation drugs in young women. https://www.fda.gov/Drugs/DrugSafety/ucm532356.htm  
• Yu CH, et al. 2018. Pregnancy outcomes following nonobstetric surgery during gestation: a nationwide population-based case-control study in Taiwan. BMC Pregnancy Childbirth, 26;18(1):460. 
• Zeleke ME, et al. 2024. Perioperative management of surgical procedure during pregnancy: a systematic review. Ann Med Surg (Lond), 86(6):3432–3441. 

Selected References

• Bird TM, et al. 2009. Demographic and environmental risk factors for gastroschisis and omphalocele in the National Birth Defects Prevention Study. J Ped Surg, 44(8):1546-1551.  
• Baldacci S, et al. 2024. Medication use during pregnancy and the risk of gastroschisis: a systematic review and meta-analysis of observational studies. Orphanet J Rare Dis, 19(1):31.  
• Banihani SA. 2019. Effect of ibuprofen on semen quality. Andrologia: 51(4):e13228. 
• Brandlistuen RE et al. 2013. Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled study. Int J Epidemiol, 42(6):1702-1713.  
• Choi E-Y, et al. 2023. Neonatal and maternal adverse outcomes and exposure to nonsteroidal anti-inflammatory drugs during early pregnancy in South Korea: a nationwide cohort study. PLoS Med, 20(2):e1004183.  
• Dawood MY. 1993. Nonsteroidal antiinflammatory drugs and reproduction. Am J Obstet Gynecol, 169(5):1255-1265.  
• Daniel S, et al. 2014. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortion. Can Med Assoc J 186(5):E177-E182. 
• Daniel S, et al. 2015. NSAIDs and spontaneous abortions – true effect or an indication bias? Br J Clin Pharmacol, 80(4):750-754. 
• Dathe K, et al. 2018. No evidence of adverse pregnancy outcome after exposure to ibuprofen in the first trimester—Evaluation of the national Embryotox cohort. Reproductive Toxicology, 79: 32-38. 
• Ericson A and Kallen BA. 2001. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol, 15:371- 375.  
• Esposito DB, et al. 2021. Periconceptional nonsteroidal anti-inflammatory drug use, folic acid intake, and the risk of spina bifida. Birth Defects Res, 113(17):1257-1266.  
• Halpern JA, et al. 2020. Effects of nonsteroidal anti-inflammatory drug (NSAID) use upon male gonadal function: A national, population-based study. Fertil Steril; 113(3):469–476. 
• Hernandez RK, et al. 2012; Nonsteroidal anti-inflammatory drug use among women and the risk of birth defects. Am J Obstet Gynecol, 206:228.e1-e8.  
• Høyer BB, et al. 2017. Use of non-prescription analgesics and male reproductive function. Reprod Toxicol; 74:70–7. 
• Kavoussi PK, et al. 2018. Ibuprofen does not have an adverse impact on semen parameters. J Assist Reprod Genet 35(12):2201-2204. 
• Killick S and Elstein M. 1987. Pharmacological production of luteinized unruptured follicles by prostaglandin synthetase inhibitors. Fertil Steril, 47:773-777. 
• Kristensen DM, et al. 2018. Ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism. Proc Natl Acad Sci U S A, 115(4):E715-E724.  
• Janssen NM and Genta MS. 2000. The effects of immunosuppressive and anti-inflammatory medication on fertility, pregnancy, and lactation. Arch Intern Med, 160:610-619.  
• Li DK, et al. 2003. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study. BMJ, 327(7411):368.  
• Martini AC, et al. 2003. Analysis of semen from patients chronically treated with low or moderate doses of aspirin-like drugs. Fertil Steril; 80(1):221–222. 
• McInerney KA, et al. 2017. Preconception use of pain-relievers and time-to-pregnancy: a prospective cohort study. Hum Reprod, 32(1):103-111. 
• Nakhai-Pour HR et al. 2011. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJv 183(15):1713-1720.  
• Nezvalova-Henriksen K et al. 2013. Effects of ibuprofen, diclofenac, naproxen, and piroxicam on the course of pregnancy and pregnancy outcome: a prospective study. BJOG, 120(8):948-959.  
• Nielsen GL, et al. 2001. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ, 322(7281):266-270.  
• Nielsen GL, et al. 2004. Danish group reanalyses miscarriage in NSAID users. BMJ, 328(7431):109.  
• NHS. 2021. Can I take ibuprofen when I’m pregnant? https://www.nhs.uk/medicines/ibuprofen-for-adults/pregnancy-breastfeeding-and-fertility-while-taking-ibuprofen/ 
• Ofori B, et al. 2006. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: a nested case-control study. Birth Defects Res B Dev Reprod Toxicol, 77(4):268-279.  
• Penfield M, et al. 2019. Ibuprofen and postpartum blood pressure in women with hypertensive disorders of pregnancy: a randomized controlled trial. Obstet Gynecol, 134(6):1219-1226. 
• Petersen TG, et al. 2018. Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child. Int J Epidemiol, 47(1):121-130. 
• Rigourd V et al. 2014. Ibuprofen concentrations in human mature milk – first data about pharmacokinetics study in breast milk with AOR-10127 “Antalait” study. Ther Drug Monitor, 36(5):590-596.  
• Torfs CP, et al. 1996. Maternal medications and environmental exposures as risk factors for gastroschisis. Teratology, 54(2):84-92.  
• Triebwasser JE, et al. 2019. A randomized-controlled trial to assess the effect of ibuprofen on postpartum blood pressure in women with hypertensive disorders of pregnancy. Pregnancy Hypertens, 18:117-121. 
• Townsend RJ, et al. 1984. Excretion of ibuprofen into breast milk. Am J Obstet Gynecol, 149(2):184-186.  
• U.S. Food and Drug Administration. 2020. FDA Warns that Using a Type of Pain and Fever Medication in Second Half of Pregnancy Could Lead to Complications. Available at: https://www.fda.gov/news-events/press-announcements/fda-warns-using-type-pain-and-fever-medication-second-half-pregnancy-could-lead-complications?utm_medium=email&utm_source=govdelivery Accessed 2 Dec 2024. 
• Uhler ML, et al. 2001. The effect of nonsteroidal anti-inflammatory drugs on ovulation: a prospective, randomized clinical trial. Fertil Steril, 76(5):957-961. 
• Zafeiri A, et al. 2022. Maternal over-the-counter analgesic use during pregnancy and adverse perinatal outcomes: cohort study of 151 141 singleton pregnancies. BMJ Open, 12(5):e048092.