Duloxetine (Cymbalta®)

Selected References

  • Ankarfeldt MZ, et al. 2021. Exposure to duloxetine during pregnancy and risk of congenital malformations and stillbirth: A nationwide cohort study in Denmark and Sweden. PLOS Medicine, 18(11):e1003851.
  • Ankarfeldt MZ, et al. 2023. Duloxetine exposure during pregnancy and the risk of offspring being born small for gestational age or prematurely: A nationwide Danish and Sweden safety study. Drugs Real World Outcomes, 10(1):69-81.
  • Bellantuono C, et al. 2015. The safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and breastfeeding: a comprehensive review. Hum Psychopharmacol, 30(3):143-51.
  • Gentile S, et al. 2019. Managing fibromyalgia syndrome in pregnancy no bridges between USA and EU. Archives of Women’s Mental Health, 22(6):711-721.
  • Hoog SL, et al. 2013. Duloxetine and pregnancy outcomes: safety surveillance findings. International Journal of Medical Sciences. 10(4):413-419.
  • Kallen B, et al. 2013. The use of central nervous system active drugs during pregnancy. Pharmaceuticals. 6(10):1221-1286.
  • Kjaersgaard MI, et al. 2013. Prenatal antidepressant exposure and risk of spontaneous abortion – a population-based study. PLoS One, 8(8):e72095.
  • Punjani N, et al. 2021. Impact of duloxetine on male fertility: A randomised controlled clinical trial. Andrologia, 53(10):e14207.
  • Richendrfer H, et al. 2018. Cluster analysis profiling of behaviors in zebrafish larvae treated with antidepressants and pesticides. Neurotoxicology Teratology, 69:54-62.


Duloxetine (Cymbalta®)

Selected References:

  • ACOG Committee Opinion No. 718: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. 2017. Obstet Gynecol, 130(3):668-669.
  • American Academy of Pediatrics. Committee on Infectious Diseases. “Red Book”: Report on the Committee on Infectious Diseases.” Elk Grove Village, IL: American Academy of Pediatrics 2021.
  • Arora M, el al. 2021. Vaccines – safety in pregnancy. Best Pract Res Clin Obstet Gynaecol. 76:23-40.
  • Baxter R, et al. 2017. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics, 139(5):e2016409.1.
  • Bernstein HH, et al. 2022. Factors Influencing Maternal Antepartum Tdap Vaccination. Matern Child Health J. 2022; 26(12): 2385–2395.
  • 2013. Updated recommendations for use of tetanus toxoid, reduced diphtheria, and acellular pertussis vaccine (Tdap) in pregnant women – Advisory Committee on Immunization Practices (ACIP), 2012. MMWR, 62(07):131-5.
  • Campbell H, et al. 2018. Review of vaccination in pregnancy to prevent pertussis in early infancy. J Med Microbiol, 67(10):1426-1456.
  • DeSilva M, et al. 2016. Tdap vaccination during pregnancy and microcephaly and other structural birth defects in offspring. JAMA, 316(17):1823-1825.
  • DiTosto JD, et al. 2021. Association of Tdap vaccine guidelines with vaccine uptake during pregnancy. 16(7):e0254863.
  • Ezeanolue E, et al. 2020. Best practices guidance of the Advisory Committee on Immunization Practices (ACIP). https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html. Accessed December 15, 2021.
  • Greenberg V. et al. 2023. Tdap vaccination during pregnancy and risk of chorioamnionitis and related infant outcomes. Vaccine. 41(22):3429-3435.
  • Hassen M, et al. Safety of maternal pertussis vaccination on pregnancy and birth outcomes:  A prospective cohort study. Vaccine, 39(2):324-331.
  • Havers FP, et al. 2020. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: Updated recommendations of the Advisory Committee on Immunization Practices – United States, 2019. MMWR Morb Mortal Wkly Rep, 69(3):77-83.
  • Kerr SM, et al. 2020. Tetanus, diptheria, and pertussis vaccine (Tdap) in pregnancy and risk of major birth defects in the offspring. Birth Defects Res, 112(5):393-403.
  • Kharbanda EO, et al. 2014. Evaluation of the association of maternal pertussis vaccination with obstetric events and birth outcomes. JAMA, 312(18):1897-1904.
  • Khromava A, et al. 2008. Immunization of pregnant women with tetanus-diphtheria-acellular pertussis (Tdap) vaccine: 29 months of data from the ADACEL vaccine pregnancy registry. Pharmacoepidemiol Drug Saf, 17(1): S194-S195.
  • Layton JB, et al. 2017. Prenatal Tdap immunization and risk of maternal and newborn adverse events. Vaccine, pii: S0264-410X(17)30868-X.
  • McMillan M, et al. 2017. Safety of tetanus diphtheria, and pertussis vaccination during pregnancy: a systematic review. Obstet Gynecol, 129(3):560-573.
  • Mooi FR and de Greeff SC. 2007. The case for maternal vaccination against pertussis. Lancet Infect Dis, 7(9):614-624.
  • Morgan JL, et al. 2015. Pregnancy outcomes after antepartum tetanus, diphtheria, and acellular pertussis vaccination. Obstet Gynecol, 125: 1433-1438.
  • Munoz FM, et al. 2014. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA, 311(17):1760-1769.
  • Nascimento RMD, et al. 2021. Protective effect of exclusive breastfeeding and effectiveiness of maternal vaccination in reducing pertussis-like illness. J Pediatr, (Rio J)97:500-507.
  • Nasser R, et al. 2019. Are all vaccines safe for the pregnant traveler? A systematic review and meta- analysis. J Travel Med, doi:10.1093/jtm/taz074.
  • National Center for Immunization and Respiratory Diseases. 2011. General recommendations on immunization — recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep, 60 (RR02):1-60.
  • Orije MRP, et al. Breast milk antibody levels in Tdap vaccinated women after preterm delivery. Clin Infect Dis, 73:e1305-e1313.
  • Panagiotakopoulos L, et al. 2020. Evaluating the association of stillbirths after maternal vaccination in the Vaccine Safety Datalink. Obstet Gynecol, 136(6):1086-1094.
  • Shakib JH, et al. 2013. Tetanus, Diphtheria, Acellular Pertussis Vaccine during Pregnancy: Pregnancy and Infant Health Outcomes. J Pediatr. 163(5):1422-6.e1-4.
  • Sukumaran L, et al. 2015. Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA, 314(15):1581-1587.
  • Sukumaran L, et al. 2015. Safety of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccinations in pregnancy. Obstet Gynecol, 126(5):1069-1074.
  • Walls T, et al. 2016. Infant outcomes after exposure to Tdap vaccine in pregnancy: an observational study. BMJ Open, (1):e009536.
  • Winter K, et al. 2012. California pertussis epidemic, 2010. The Journal of Pediatrics, 161(6):1091-1096.
  • Zheteyeva YA, et al. 2012. Adverse event reports after tetanus toxoid reduced diphtheria toxoid and acellular pertussis vaccines in pregnant women. Am J Obstet Gynecol, 207(1):59.e1-59.e7.
  • Zimmermann P, et al. 2019. The effect of maternal immunization during pregnancy on infant vaccine responses. EClinicalMedicine, 13:21-30.


Duloxetine (Cymbalta®)

Selected References:

  • Brent B, Wisner K. 1998. Fluoxetine and carbamazepine concentrations in a nursing mother/infant pair. Clin Pediatr; 37:41-4.
  • Burdine J, Luedtke S. 2021. Serotonin Toxicity Versus Withdrawal: Clonidine One Size Fits All? The journal of pediatric pharmacology and therapeutics: JPPT: the official journal of PPAG ;26(5):502-17.
  • Freeman MP, et al. 2022. Pregnancy outcomes after first-trimester exposure to buspirone: prospective longitudinal outcomes from the MGH National Pregnancy Registry for Psychiatric Medications. Arch Women’s Mental Health ;25(5):923-928.
  • Meltzer HY et al. 1983. The effect of buspirone on prolactin and growth hormone secretion in man. Arch Gen Psychiatry 40:1099-102.
  • Newport D, Ritchie J, Knight B, et al. 2009. Venlafaxine in human breast milk and nursing infant plasma: Determination of exposure. J Clin Psychiatry ;70:1304-10.


Duloxetine (Cymbalta®)

Referencias Seleccionadas 

  • 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 8/2023]. 
  • 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.  
  • 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. 
  • 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.  
  • Wheeler SM, et al. 2015. Maternal Effects of Respiratory Syncytial Virus Infection during Pregnancy. Emerg Infect Dis; 21(11):1951-1955. 


Duloxetine (Cymbalta®)

Selected References:

  • American College of Obstetricians and Gynecologists. 2021. ACOG Practice Bulletin no 230: Obesity in Pregnancy. Obstet Gynecol.137(6),p e128–e144
  • American College of Obstetricians and Gynecologists. 2013. ACOG Committee opinion no. 548: Weight Gain During Pregnancy. Available at: https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co548.pdf?dmc=1&ts=20180102T2046334047
  • Amiri and Ramezani Tehrani F. 2020. Potential Adverse Effects of Female and Male Obesity on Fertility: A Narrative Review. Int J Endocrinol Metab. 18(3): e101776.
  • Andersen C, et al. 2018. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children. Eur Child Adolesc Psychiatry; 27: 139-148.
  • Cai GJ, et al. 2014. Association between maternal body mass index and congenital heart defects in offspring: a systematic review. Am J Obstet Gynecol. 211(2):91-117.
  • Catalano PM and Shankar K 2017. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ 356:j1.
  • Dong M, et al. 2013. Maternal obesity, lipotoxicity & cardiovascular diseases in offspring. J Mol Cell Cardiol; 55:111-6.
  • Gilboa SM, et al. 2010. Association between prepregnancy body mass index and congenital heart defects. Am J Obstet Gynecol 202:51.e1-10.
  • Huang l, et al. 2014. Maternal prepregnancy obesity and child neurodevelopment in the Collaborative Perinatal Project. Int. J Epidemiol. 43(3):783-92.
  • Jarlenski M, et al. 2014. Association between support from a health professional and breastfeeding knowledge and practices among obese women: Evidence from the Infant Practices Study II. Women’s Health Issues ;24(6):641–648.
  • Johnson J, et al. 2013. Eunice Kennedy Shriver National Institute of Child Health; Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines. Obstet Gynecol. 121(5):969-75.
  • Lyons S, et al. 2019. Learning from Women with a Body Mass Index (Bmi) ≥ 30 kg/m2 who have Breastfed and/or are Breastfeeding: a Qualitative Interview Study. Maternal and child health journal, 23(5), 648–656.
  • Matias S, et al. 2021. Maternal prepregnancy weight and gestational weight gain in association with autism and developmental disorders in offspring. Obesity (Silver Spring); 29(9):1554-1564.
  • Mohammadbeigi A, et al. 2013. Fetal macrosomia: risk factors, maternal, and perinatal outcome. Ann Med Health Sci Res. Oct;3(4):546-50.
  • Nohr EA, et al. 2021. Cause-specific stillbirth and neonatal death according to prepregnancy obesity and early gestational weight gain: a study in the Danish National Birth Cohort. Nutrients; 13(5):1676.
  • Persson M, et al. 2017. Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons. BMJ 357:j2563.
  • Sibai BM, et al. 1997. Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol; 177:1003-1010.
  • Silvestris E, et al. 2018. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol; 16:22-22.
  • Stothard KJ,et al. 2009. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 11;301(6):636-50.
  • Stubert J, et al. 2018. The risks associated with obesity in pregnancy. Dtsch Arztebl Int 115(16):276-283.
  • Tanda L, et al. 2013. The impact of prepregnancy obesity on children’s cognitive test scores. Matern Child Health J. 17:222-229.
  • Vats H, et al. 2021. Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide populations: a systematic review and meta-analysis. Obes Res Clin Pract; 15:536-545.
  • Wang et al. 2021. Does obesity based on body mass index affect semen quality?-A meta-analysis and systematic review from the general population rather than the infertile population. Andrologia. 53(7):e14099.