OnabotulinumtoxinA (Botox®)

Selected References:

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  • Briggs J, et al. 2005. Drugs in pregnancy and lactation, 7th Ed. 174-175. Lippincott Williams & Wilkins: Philadelphia. 
  • Brin MF, et al. 2016. Pregnancy outcomes following exposure to onabotulinumtoxinA. Pharmacoepidemiology and Drug Safety. 25: 179–187. 
  • Brin, MF, et al 2023. Pregnancy outcomes in patients exposed to onabotulinumtoxinA treatment. Neurology. 101: e103-e113. 
  • Cardon BR, Smith ME, Cerrati EW. 2021 May-June. Case Series of Botulinum Toxin Administered to Pregnant Patients and Review of the Literature. Facial Plast Surg Aesthet Med. 23(3):187-190. De Oliveira Monteiro E. 2006. Botulinum toxin and pregnancy. Skinmed 5(6): 308.
  • Li Yim and Weir CR. 2010. Botulinum toxin and pregnancy – cautionary tale. Strabismus 18(2): 65-66. 
  • Morgan JC, et al. 2006. Botulinum toxin A during pregnancy: a survey of treating physicians. J Neurol Neurosurg Psychiatry 77 (1) 117-119. 
  • Newman W.J., et al 2004. OnabotulinumtoxinA therapy during pregnancy. Mov Disord 19(11): 1384-1385. 
  • Polo JM, et al. 1996. Botulism and pregnancy. Lancet 348: 195. 
  • Robinson AY, Grogan PM. OnabotulinumtoxinA successfully used as migraine prophylaxis during pregnancy: a case report. Mil Med. 2014 Jun;179(6):e703-4. 
  • St. Clair EH, et al. 1975. Observations of an infant born to a mother with botulism. J Pediatr 87: 658. 
  • Wataganara T, et al. 2009. Treatment of severe achalasia during pregnancy with esophagoscopic injection of botulinum toxin A: a case report. J Perinatol 29(9): 639. 
  • Wong HT, et al. 2020. OnabotulinumtoxinA for chronic migraine during pregnancy: a real-world experience on 45 patients. J Headache Pain. 21(1):129.  
  • Wong HT, et al. 2025. OnabotulinumtoxinA treatment for chronic migraine in pregnancy: An updated report of real-world headache and pregnancy outcomes over 14 years in Hull. Cephalalgia 45(5):3331024251327387.  


OnabotulinumtoxinA (Botox®)

Selected References:

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  • Battarbee AN, et al. 2020. Chronic hypertension in pregnancy. Am J Obstet Gynecol; 222(6):532-541. 
  • Davis RL, et al. 2011. Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy. Pharmacoepidemiol Drug Saf. 20(2):138-145. 
  • Duan L, et al. 2017. b-Blocker exposure in pregnancy and risk of fetal cardiac anomalies. JAMA Intern Med. 177(6): 885-887. 
  • Duan L, et al. 2018. Beta-blocker subtypes and risk of low birth weight in newborns. J Clin Hypertens 20(11):1603-1609. 
  • Firoz T, et al. 2014. Community Level Interventions for Pre-Eclampsia (CLIP) Working Group. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG. 121(10):1210-1218. 
  • Kulas J et al. 1984. Atenolol and metoprolol.  A comparison of their excretion into human breast milk.  Acta Obstet Gynecol Scand Suppl. 118: 65-69. 
  • Lindeberg S et al. 1984. Disposition of the adrenergic blocker metoprolol in the late-pregnant woman, the amniotic fluid, the cord blood and the neonate. Acta Obstet Gynecol Scand Suppl. 118: 61-64. 
  • Ruys TP, et al. 2014. Cardiac medication during pregnancy, data from the ROPAC. Int J Cardiol. 15. 177(1):124-8. 
  • Sandstrom B, Regardh CG. 1980. Metoprolol excretion in breast milk. Br J Clin Pharmacol. 9: 518-519.  
  • Tamirisa KP, et al. 2022. Arrhythmias in Pregnancy. JACC Clin Electrophysiol. 8(1):120-135. 
  • Tanaka K, 2016. Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circ J. 80(10):2221-2226.  
  • Welzel T, et al. 2021.Intrauterine Growth Retardation in Pregnant Women with Long QT Syndrome Treated with Beta-Receptor Blockers. Neonatology. 118(4):406-415.  
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  • Xie RH, et al. 2014. Beta-blockers increase the risk of being born small for gestational age or of being institutionalised during infancy. BJOG. 121(9):1090-1096. 
  • Yakoob MY, et al. 2013. The risk of congenital malformations associated with exposure to β-blockers in pregnancy: a meta-analysis. Hypertension 62(2):375-381. 


OnabotulinumtoxinA (Botox®)

Selected References:

  • Bateman BT, et al. 2016. Late pregnancy β blocker exposure and risks of neonatal hypoglycemia and bradycardia. Pediatrics 138(3) pii:e20160731. 
  • Bauer et al. 1979. Propranolol in human plasma and breast milk. Am J Cardiol 43(4):860-862. 
  • Bratton S, et al. 2024. Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis. Journal of Perinatal Medicine. 52.8: 858-862. 
  • Davis RL, et al. 2011. Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy. Pharmacoepidemiol Drug Saf. 20(2):138-45.  Duan L, et al. 2017. b-Blocker exposure in pregnancy and risk of fetal cardiac anomalies. JAMA Intern Med
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  • Duan L, et al. 2018. Beta-blocker subtypes and risk of low birth weight in newborns. J Clin Hypertens 20(11):1603-1609. 
  • Firoz T, et al. 2014. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG 121(10):1210-1218. 
  • Fischer AJ, et al. 2021. Antiarrhythmic drugs – safety and efficacy during pregnancy. Herzschrittmacherther Elektrophysiol 32(2): 145-151. 
  • Freppel R, et al. 2024. Beta-blockers and breastfeeding: a real-life prospective study. Eur J Clin Pharmacol. 80(12):1937-1943.  
  • Halpern DG, et al. 2019. Use of medication for cardiovascular disease during pregnancy: JACC state-of-the-art review. Journal of the American College of Cardiology. 73.4: 457-476. 
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  • pregnancy, data from the ROPAC. Int J Cardiol. 177(1):124-128.  
  • Salman M, et al. 2016. Erectile dysfunction: prevalence, risk factors, and involvement of antihypertensive drugs intervention. Trop J Pharm Res 15(4)869-876. 
  • Smith MT et al. 1983. Propranolol, propranolol glucuronide, and naphthoxylactic acid in breast milk and plasma. Ther Drug Monit. 5(1):87-93. 
  • Tanaka K, et al. 2016. Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circ J 80(10):2221-2226. Taylor EA, Turner P. 1981. Anti-hypertensive therapy with propranolol during pregnancy and lactation.  Postgrad Med J 57(669):427-430. 
  • Thorley KJ, McAinish J. 1983. Levels of the beta-blockers atenolol and propranolol in the breast milk of women treated for hypertension in pregnancy.  Biopharm Drug Dispos. 4(3):299-301. 
  • Turnstall ME. 1969. The effect of propranolol on the onset of breathing at birth. Br J Anaesth 41(9):792. 
  • Welzel T, et al. 2021. Intrauterine growth retardation in pregnant women with Long QT syndrome treated with beta-receptor blockers. Neonatology 118(4)406-415. 
  • Xie RH, et al. 2014. Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. Eur J Obstet Gynecol Reprod Biol 175:124-128. 
  • Xie RH, et al. 2014. Beta-blockers increase the risk of being born small for gestational age or of being institutionalized during infancy. BJOG. 121(9):1090-1096. 
  • Yakoob MY, et al. 2013. The risk of congenital malformations associated with exposure to β-blockers in pregnancy: a meta-analysis. Hypertension 62(2):375-381. 

 


OnabotulinumtoxinA (Botox®)

Selected References:

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OnabotulinumtoxinA (Botox®)

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