Selected References:

• Chuang H et al. 2024. Concomitant use of antidepressants and benzodiazepines during pregnancy and associated risk of congenital malformations: a population-based cohort study in Taiwan. The Lancet Psychiatry 8: 601-10.
• Estazolam. Product labeling. 8/2022. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a1e3b4bf-22e9-430a-a768-4d86ae886c9e&type=display.  

Selected References:

• American College of Obstetricians and Gynecologists (ACOG). 2017. Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Committee Opinion no. 718.
• American College of Obstetricians and Gynecologists (ACOG). 2018. Maternal Immunization. Committee Opinion no. 741.
• American College of Obstetricians and Gynecologists (ACOG). 2019. Influenza vaccination during pregnancy. Committee Opinion no. 732.
• Centers for Disease Control and Prevention (CDC). 2022. Guidelines for vaccinating pregnant women. Available at: https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html
• Centers for Disease Control and Prevention (CDC). 2023. Vaccines During Pregnancy FAQs. Available at: https://www.cdc.gov/vaccinesafety/concerns/vaccines-during-pregnancy.html
• Centers for Disease Control and Prevention (CDC). 2020. Vaccinations: breastfeeding guidelines & recommendations. Available at: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/vaccinations.html
• Etti M, et al. 2022. Maternal vaccination: a review of current evidence and recommendations. Am J Obstet Gynecol. Apr;226(4):459-474.
• Giles ML, et al. 2019. The safety of inactivated influenza vaccines in pregnancy for birth outcomes: a systematic review. Hum Vaccin Immunother 15(3):687-699.
• Keller-Stanislawski B, et al. 2014. Safety of immunization during pregnancy: a review of the evidence of selected inactivated and live attenuated vaccines. Vaccine. 32(52):7057-64.
• Ohfuji S, et al. 2020. Safety of influenza vaccination on adverse birth outcomes among pregnant women: A prospective cohort study in Japan. Int J Infect Dis 93:68-76.
• Shafiee A, et al. 2023. COVID-19 vaccination during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. Jan 20;23(1):45
• Vygen-Bonnet S, et al. 2020. Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review. BMC Infect Dis 20(1):136.
• Zhang C, et al. 2018. A systematic review and meta-analysis of fetal outcomes following the administration of influenza A/H1N1 vaccination during pregnancy. Int J Gynaecol Obstet 141(2):141-150.

Selected References:  

• Ahmadi R, et al. 2015. International conference of social science, medicine and nursing, Istanbul, Turkey.  
• Altshuler LL, et al. 1996. Pharmacologic management of psychiatric illness during pregnancy: Dilemmas and guidelines. Am J Psychiatry. 153:592-606. 
• Ang MS, et al. 1990. Maternal lithium therapy and polyhydramnios. Obstet Gynecol. 76(3 Pt 2):517-519. 
• Cohen LS, et al. 1994. A reevaluation of risk of in utero exposure to lithium. JAMA. 271(2):146-150.  
• Diav-Citrin O, et al. 2014. Pregnancy outcome following in utero exposure to lithium: a prospective, comparative, observational study. Am Journal of Psychiatry. 171:785-794.  
• Di Florio A, et al. 2017. Lithium use in pregnancy and the risk of cardiac malformations. N Engl J Med. 377(9):893.  
• Forsberg L, et al. 2017. Maternal mood disorders and lithium exposure in utero were not associated with poor cognitive development during childhood. Acta Paediatr. Doi:10.1111/apa.14152. 
• Goodnick PJ, et al. 1982 Differences in lithium kinetics between bipolar and unipolar patients. J Clin Psychopharmacol. 2:48-50. 
• Hastie R, et al. 2021. Maternal lithium use and the risk of adverse pregnancy and neonatal outcomes: a Swedish population-based cohort study. BMC Med. 19(1):291. 
• Jacobsen SJ. et al. 1992. Prospective multicentre study of pregnancy outcome after lithium exposure during first trimester. Lancet. 339:530-533.  
• Khan SJ, et al. 2016. Bipolar disorder in pregnancy and postpartum: principles of management. Curr Psychiatry Rep. 18(2):13.  
• Kozma C. 2005. Neonatal toxicity and transient neurodevelopmental deficits following prenatal exposure to lithium: Another clinical report and review of the literature. Am J Med Genet. 132A:441-444. 
• Krause S, et al. 1990. Polyhydramnios with maternal lithium treatment. Obstet Gynecol. 75(3 Pt 2):504-6. 
• Kummerlowe MN, et al. 2024. Retrospective review of postpartum lithium use including during lactation. Breastfeed Med. 19(10):796-800. 
• Lithium FDA Full Prescribing Information. 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/017812s033,018421s032,018558s027lbl.pdf.   
• Molenaar NM, et al. 2021, Management of lithium dosing around delivery: an observational study. Bipolar Disord. 23(1):49-54. 
• Morrell P. et al. 1983. Lithium toxicity in the neonate. Arch Dis Child. 58:539-541.  
• Newport DJ, et al. 2005. Lithium placental passage and obstetrical outcome: implications for clinical management during date pregnancy. Am J Psychiatry. 162(11):2162-2170.  
• Patorno E, et al. 2017.  Lithium use in pregnancy and the risk of cardiac malformations. N Engl J Med. 376(23):2245-54.  
• Poels EMP, et al. 2020. Lithium use during pregnancy and the risk of miscarriage. J Clin Med. 9(6). 
• Poels EMP, et al. 2022. The effect of prenatal lithium exposure on the neuropsychological development of the child. Bipolar Disord. 24(3):310-319. 
• Raoof NT, et al. 1989. Lithium inhibits human sperm motility in vitro. Br J Clin Pharmac. 28, 715-717. 
• Robert E. et al. 1990. Comments on teratogen update on lithium by J. Warkany. Teratology. 42:205. 
• Schmidt CT, et al. 2023. Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis. Prog Neuropsychopharmacol Biol Psychiatry. 8;124:110733. 
• Schou M. 1990. Lithium treatment during pregnancy, delivery, and lactation: an update. Journal of Clinical Psychiatry. 51(10):410-413.  
• Smith CJ, Payne VM. 2024. Epidemiology studies on effects of lithium salts in pregnancy are confounded by the inability to control for other potentially teratogenic factors. Hum Exp Toxicol. 43:9603271241236346. 
• Stoppa A, et al. 2024. A case of pregnancy with severe polyhydramnios related to long-term use of lithium. Bipolar Disord. 26(4):405-408. 
• Van der Lugt NM, et al. 2012. Fetal, neonatal and developmental outcomes of lithium-exposed pregnancies. Early Hum Dev. 88(6):375-378. 
• Viguera AC, et al. 2000. Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry. 157(2):179-184.  
• Viguera AC, et al.2007. Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry. 164(12):1817-1824. 
• Viguera AC, et al. 2007. Lithium in breast milk and nursing infants: clinical implications. Am J Psychiatry 164(2):342-345. 
• Zivanovic O. 2017. Lithium: A classic drug frequently discussed, but, sadly, seldom prescribed! Aust N Z J Psychiatry 4867417695889. 

Selected References:

• Akhigbe RE, et al. 2022. Codeine alters female reproductive function by targeting ovarian steroidogenesis and folliculogenesis via the induction of oxidative stress, inflammation, and apoptosis, Reproductive Toxicology 109: 1-9.  
• Azuine RE, et al. 2019. Prenatal risk factors and perinatal and postnatal outcomes associated with maternal opioid exposure in an urban, low-income, multiethnic US population. JAMA network 2(6): e196405-196405.  
• Berlin CM, Jr, et al. 2009. Safety issues of maternal drug therapy during breastfeeding. Clinical pharmacology and therapeutics  85(1): 20-22. 
• Bowie, AC, et al. 2022. Prescribed opioid analgesics in early pregnancy and the risk of congenital anomalies: a population-based cohort study. CMAJ. 194(5): E152-E162. 
• Bracken MB. 1986. Drug use in pregnancy and congenital heart disease in offspring. N Engl J Med. 314(17):1120. 
• Bracken MB, Holford TR. 1981. Exposure to prescribed drugs in pregnancy and association with congenital malformations. Obstet Gynecol. 58(3):336-344. 
• Brogly SB, et al. 2021. Prenatal opioid analgesics and the risk of adverse birth outcomes. Epidemiology. 32(3), 448–456. 
• Brogly SB, et al. 2023. Safety of prenatal opioid analgesics: Do results differ between public health insurance beneficiary and population-based cohorts? Birth Defects Res. 115(5):555-562. 
• Broussard CS, et al. 2011. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol. 204(4):314.e1-11.
• Corsi DJ, et al. 2020. Association of Maternal opioid use in pregnancy with adverse perinatal outcomes in Ontario, Canada, From 2012 to 2018. JAMA Netw Open. 3(7):e208256. 
• Corsi DJ, et al. 2021. The effects of opioids on female fertility, pregnancy and the breastfeeding mother‐infant dyad: A Review. Basic Clin Pharmacol Toxicol. 128(5):635-641. 
• Esposito, DB, et al. 2022. Characteristics of prescription opioid analgesics in pregnancy and risk of neonatal opioid withdrawal syndrome in newborns. JAMA Netw Open 5(8): e2228588. 
• Fältmarch S, et al. 2019. Use of opioids during pregnancy and effects of pregnancy outcomes. Pharmacoepidemiol Drug Saf. 28: 1239– 1245.  
• Fishman B, et al. 2019. Pregnancy outcome following opioid exposure: A cohort study. PLOS ONE 14(7): e0219061 
• Flannagan KS, et al. 2020. Is opioid use safe in women trying to conceive? Epidemiology. 31(6): 844–851. 
• Fronczak CM, et al. 2012. The insults of illicit drug use on male fertility. Journal of andrology. 33(4): 515-528. 
• Interrante JD, et al. 2021. Prescription opioid use during pregnancy and risk for preterm birth or term low birthweight. Journal of opioid management 17(3):215-225. 
• Ito S. 2018. Opioids in breast milk: Pharmacokinetic principles and clinical implications. The Journal of Clinical Pharmacology, 58: S151-S163. 
• Juurlink DN, et al. 2012. Postpartum maternal codeine therapy and the risk of adverse neonatal outcomes: a retrospective cohort study. Clinical Toxicol. 50:5.  
• Kallen B,  Reis M. 2015. Use of tramadol in early pregnancy and congenital malformation risk. Reprod Toxicol. 58:246-251. 
• Kelly LE, et al. 2013. A clinical tool for reducing central nervous system depression among neonates exposed to codeine through breast milk. PLoS ONE. 8(7):370073. 
• Khan K,  Chang J. 1997. Neonatal abstinence syndrome due to codeine. Arch Dis Child. 76:F59-F60.  
• Konijnenberg C, el at. 2022. Verbal and nonverbal memory in school-aged children born to opioid-dependent mothers. Early human development, 171, 105614. 
• Lazaryan M,  et al. 2015. Codeine should not be prescribed for breastfeeding mothers or children under the age of 12. Acta paediatrica 104(,6): 550-556. 
• Lind JN, et al. 2017. Maternal use of opioids during pregnancy and congenital malformations. A Systematic Review. Pediatrics. 139(6):e20164131.  
• Mactier H, et al. 2020. Prenatal opioid exposure – Increasing evidence of harm. Early human development, 150, 105188. 
• Mangurten HH. 1980. Neonatal codeine withdrawal in infants of non-addicted mothers. Pediatrics. 65:159-160. 
• Meny RG, et al. 1993. Codeine and the breastfed neonate. Journal of human lactation  9(4): 237-240. 
• Nair V, et al. 2012. Neonatal withdrawal syndrome due to maternal codeine use. Paediatr Child Health. 17(5):e40-e41. 
• Nezvalová-Henriksen K, et al. 2011. Effects of codeine on pregnancy outcomes from a large population-based cohort study. Eur J Clin Pharmacol. 67:1253-1261. 
• Rothman KJ, et al. 1979. Exogenous hormones and other drug exposures of children with congenital heart disease. Am J Epidemiol. 109(4):433-439. 
• Rubenstein E, et al. 2019. Brief Report: Maternal opioid prescription from preconception through pregnancy and the odds of autism spectrum disorder and autism features in children. Journal of autism and developmental disorders, 49(1): 376–382. 
• Saxén I. 1975. Associations between oral clefts and drugs taken during pregnancy. Int J Epidemiol. 4(1):37-44. 
• Sachs, Hari Cheryl, and Committee On Drugs. 2013. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics  132(3): e796-809. 
• Shaw GM, et al. 1992. Congenital cardiac anomalies relative to selected maternal exposures and conditions during early pregnancy. Eur J Epidemiol. 8(5):757-760. 
• Shaw GM, et al. 1998. Maternal illness, including fever and medication use as risk factors for neural tube defects. Teratology. 57(1):1-7. 
• Semet M, et al. 2017. The impact of drugs on male fertility: a review. Andrology, 5(4), 640-663. 
• Sujan AC, et al. 2019. Maternal prescribed opioid analgesic use during pregnancy and associations with adverse birth outcomes: A population-based study. PLoS Medicine. 16(12). 
• U.S. Food and Drug Administration. 2017. Use of codeine and tramadol products in breastfeeding women – questions and answers. Available at https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/use-codeine-and-tramadol-products-breastfeeding-women-questions-and-answers. Accessed 2 June 2025.   
• Van Leeuwen G, et al. 1965. Narcotic withdrawal reaction in a newborn infant due to codeine. Pediatrics. 36:635-636. 
• Varney B, et al. 2024. Opioid analgesic exposure during the first trimester of pregnancy and the risk of major congenital malformations in infants: a systematic review and meta-analysis†. Anaesthesia. 79(9):967-977. 
• Willmann, S, et al. 2009. Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study. Clin Pharmacol Ther. 86, 634–643. 
• Yazdy MM, et al. 2013. Periconceptional use of opioids and the risk of neural tube defects. 2013. Obstet Gynecol. 122(4):838-844. 
• Zierler S, Rothman KJ. 1985. Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy. N Engl J Med. 313(6):347-352. 
• Zipursky J, Juurlink DN. 2020. The implausibility of neonatal opioid toxicity from breastfeeding. Clin Pharmacol Ther. 108(5):964-970. 

Selected References:

• Aman F, et al. 2012. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol, 9:256-264.
• Amant F, et al. 2019. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann Oncol, 30(10):1601-1612.
• Aviles A, et al. 2001. Hematological malignancies and pregnancy: a final report of 84 children who received chemotherapy in utero. Clin Lymphoma, 2(3):173-177.
• Cardonick EH, et al. 2015. Development of children born to mothers with cancer during pregnancy: comparing in utero chemotherapy-exposed children with nonexposed controls. Am J Obstet Gynecol, 212(5):658.e1-658.e8.
• de Haan J et al. 2018. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol, 19:337-346.
• Hahn KM, et al. 2006. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer, 107(6):1219-1226.
• Huis In ‘t Veld EA, Van Assche IA, Amant F. Long-term outcomes of children after prenatal exposure to maternal cancer and its treatment. Acta Obstet Gynecol Scand. 2024;103(4):757-760.
• Ebert U, et al. 1997. Cytotoxic therapy and pregnancy. Pharmacology & Therapeutics 74(2):207-220.Hope For Two: The Pregnant with Cancer Network. [Cited 2010 August 16]. Available at URL: http://www.pregnantwithcancer.org.
• Imai A, et al. 2008. Preservation of female fertility during cancer treatment. Reprod Med Biol, 7(1):17-27.
• National Cancer Institute. 2009. General information about breast cancer and pregnancy. [Cited 2010 August 16]. Available at URL: http://www.cancer.gov/cancertopics/pdq/treatment/breast-cancer-and-pregnancy/Patient.
• National Cancer Institute. 2009. Understanding chemotherapy: a guide for patients and families. [Cited 2010 August 16]. Available at URL: http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Chemotherapy/UnderstandingChemotherapyAGuideforPatientsandFamilies/understanding-chemotherapy-a-guide-toc.
• Ngu SF, et al. 2016. Chemotherapy in pregnancy. Best Pract Res Clin Obstet Gynaecol, 33:86-10.
• Signorello LB, et al. 2012. Congenital anomalies in the children of cancer survivors: a report from the childhood cancer survivor study. J Clin Oncol, 30(3):239-4
• Welt CK and Shapiro CL. 2010. Ovarian failure due to anticancer drugs and radiation. [Updated Sep. 2019].