Sulfasalazine (Azulfidine®)

Selected References:

  • Birnie GG, et al. 1981. Incidence of sulphasalazine-induced male infertility. Gut 22:452-455.
  • Bokstrom H, et al. 2006. Fetal hemolytic anemia associated with maternal sulfasalazine therapy during pregnancy. Acta Obstet Gynecol Scand 85:118-121.
  • Connell W, Miller A. 1999. Treating inflammatory bowel disease during pregnancy: Risks and safety of drug therapy. Drug Saf 21:311-323.
  • Chatzionaff M, et al. 1988. Sulfasalazine-induced abnormal sperm penetration assay reversed on changing to 5-aminosalicylic acid enemas. Dig Dis Sci 33:108-110.
  • Hernandez-Diaz S, et al. 2000. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 343:1608-1614.
  • Hoo JJ, et al. 1988. Possible teratogenicity of sulfasalazine. New Engl J Med 318:112.
  • Jarnerot G, et al. 1981. Albumin reserve for binding of bilirubin in maternal and cord serum under treatment with sulphasalazine. Scand J Gastroenterol 16:1049-1055.
  • Klarsov P, et al. 2013. Short-acting sulfonamides near term and neonatal jaundice. Obstet Gynecol 122:105-110.
  • Levi AJ, Fisher AM. 1979. Male infertility due to sulphasalazine. Lancet 2:276-278.
  • Levi S, et al. 1988. Reversible congenital neutropenia associated with maternal sulphasalazine therapy (letter). Euro J Pediatr 48:174-175.
  • Mogadam M, et al. 1981. Pregnancy in inflammatory bowel disease: effect of sulfasalazine and corticosteroids on fetal outcome. Gastroenterology 80:72-76.
  • Moody GA, et al. 1997. The effects of chronic ill health and treatment with sulphasalazine on fertility amongst men and women with inflammatory bowel disease in Leicestershire. Int J Colorectal Dis 12:220-224
  • Newman NM, Correy JF. 1983. Possible teratogenicity of sulphasalazine. Med J Aust 1:528-1529.
  • Nielsen OH, et al. 1983. Pregnancy in ulcerative colitis. Scand J Gastroenterol 18(6):735-742.
  • Norgard B, et al. 2001. Population-based case control study of the safety of sulfasalazine use during pregnancy. Aliment Pharmacol Ther 15:483-486.
  • Norgard B, et al. 2003. Risk of congenital abnormalities in children born to women with ulcerative colitis: a population-based, case-control study. Am J Gastroenterol 98:2006-2010.
  • Norgard B, et al. 2007. Therapeutic drug use in women with Crohns disease and birth outcomes: a Danish nationwide cohort study. Am J Gastroenterol 102(7):1406-1413.
  • Toovey S, et al. 1981. Sulphasalazine and male infertility: Reversibility and possible mechanism. Gut 22:445-451.
  • Toth A. 1979. Male infertility due to sulphasalazine. Lancet 2:904.
  • Toth A. 1979. Reversible toxic effect of salicylazosulfapyridine on semen quality. Fertil Steril 1:538-540.
  • Viktil KK, et al. 2012. Outcomes after anti-rheumatic drug use before and during pregnancy: a cohort study among 150,000 pregnant women and expectant fathers. Scand J Rheumatol. 41(3):196-201.


Sulfasalazine (Azulfidine®)

Selected references.  

  • Deleuran M, et al. 2024. Systemic anti-inflammatory treatment of atopic dermatitis during conception, pregnancy and breastfeeding: Interdisciplinary expert consensus in Northern Europe. J Eur Acad Dermatol Venereol 38:31-41.
  • Product Information. 2021. ADBRY(TM) subcutaneous injection, tralokinumab-ldrm subcutaneous injection. LEO Pharma Inc. 
  • Stratigakis A, et al. 2023. A regression approach for assessing large molecular drug concentration in breast milk. Reprod Breed;3:199-207.  


Sulfasalazine (Azulfidine®)

Selected References:

  • Allan-Blitz L.T, Klausner J.D. 2023. Current Evidence Demonstrates That Monkeypox Is a Sexually Transmitted Infection. Sex Transm Dis. 1;50(2):63-65.
  • Centers for Disease Control and Prevention. 2024. Preventing Mpox. Accessed September 2024 https://www.cdc.gov/mpox/prevention/index.html.
  • Centers for Disease Control and Prevention. 2024. Safer Sex. Accessed September 2024 https://www.cdc.gov/mpox/prevention/safer-sex-social-gatherings-and-mpox.html.
  • García-Hernández L, et al. 2024. Case report: clinical presentation of Mpox in pregnancy. Rev Clin Esp (Barc). (4):245-247.
  • Jamieson DJ, et al. 2004. The role of the obstetrician–gynecologist in emerging infectious diseases: mpox and pregnancy. Obstetrics & Gynecology 103(4):754-756.
  • Khalil A, et al. 2022. Mpox and pregnancy: what do obstetricians need to know? Ultrasound Obstet Gynecol; 60(1):22-27.
  • Kisalu NK and Mokili JL. 2017. Toward understanding the outcomes of mpox infection in human pregnancy. J Infectious Diseases 216(7):795–797.
  • Mbala PK, et al. 2017. Maternal and fetal outcomes among pregnant women with human mpox infection in the Democratic Republic of Congo. J Infectious Diseases 216(7):824-828.
  • Nishiura H. 2009. Maternal outcomes in pregnancy with smallpox: epidemiologic investigations of case fatality, miscarriage and premature birth based on previous outbreaks. In: Canfield RN, ed. Infectious Pregnancy Complications. Nova Science Publishers, Inc.; 2009:407-420.
  • Ogoina D, et al. 2020. Clinical course and outcome of human mpox in Nigeria. Clin Infect Dis. 71:e210–e214.
  • Rao AK, et al. 2023. Interim Clinical Treatment Considerations for Severe Manifestations of Mpox — United States, February 2023. MMWR Morb Mortal Wkly Rep 72:232–243.
  • Sampson MM, et al. 2023. Mpox (Mpox) Infection During Pregnancy. Obstet Gynecol. 1;141(5):1007-1010.
  • Schwartz DA. 2024. High Rates of Miscarriage and Stillbirth among Pregnant Women with Clade I Mpox (Mpox) Are Confirmed during 2023-2024 DR Congo Outbreak in South Kivu Province. Viruses. 13;16(7):1123.
  • World Health Organization. 2022. WHO recommends new name for Monkeypox disease. Accessed September 2024 https://www.who.int/news/item/28-11-2022-who-recommends-new-name-for-monkeypox-disease.


Sulfasalazine (Azulfidine®)

Selected References:

  • Allan KM, et al. 2015. Maternal vitamin D and E intakes during pregnancy are associated with asthma in children. Eur Respir J. 2015 Apr;45(4):1027-1036.
  • Ashraf M, et al. 2020. Changes in vitamin E levels as a marker of female infertility. J Pak Med Assoc 70(10): 1762-1766.
  • Beers MH, et al. 1999. Merck Manual Diagnosis & Therapy, 17th ed., 2833.
  • Boskovic R, et al. 2005. Pregnancy outcome following high doses of vitamin E supplementation. Reprod Toxicol 20:85-88.
  • Gilboa SM, et al. 2014. National Birth Defects Prevention Study. Maternal intake of vitamin E and birth defects, national birth defects prevention study, 1997 to 2005. Birth Defects Res A Clin Mol Teratol. 100(9):647-657.
  • Gross SJ, Gabriel E. 1985. Vitamin E status in preterm infants fed human milk or infant formula. J Pediatr 106:635-639.
  • Gyorgy P, et al. 1952. Availability of vitamin E in the newborn infant. Proc Soc Exp Biol Med 81:536-538.
  • Hook EB, et al. 1074. Vitamin E, Teratogen or anti-teratogen? Lancet 1:809.
  • Kanno C, et al. 1989. Transfer of orally administered alpha-tocopherol into human milk. J Nutr Sci Vitaminol (Tokyo) 35:649-653.
  • Martinez Fe, et al. 1984. Evaluation of plasma tocopherols in relation to hematological indices of Brazilian infants on human milk and cow’s milk regime from birth to 1 year of age. Am J Clin Nutr 39:969-974.
  • Maslova E, et al. 2014. 2014. Maternal intake of vitamins A, E and K in pregnancy and child allergic disease: a longitudinal study from the Danish National Birth Cohort. British J Nutr 111: 1096-1108.
  • Mino M, Nishino H. 1973. Fetal and maternal relationship in serum vitamin E level. J Nutr Sci Vitaminol 19:475-482.
  • National Institutes of Health Office of Dietary Supplements. 2021. Vitamin E: Fact Sheet for Health Professionals. Available at: https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/. Accessed 3 July 2024.
  • Scholl TO, et al. 2006. Vitamin E: maternal concentrations are associated with fetal growth. Am J Clin Nutr 84(6):1442-1448.
  • Smedts HP, et al. 2009. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG. 116(3):416-423.
  • Ruder EH, et al. 2014. Female dietary antioxidant intake and time to pregnancy among couples treated for unexplained infertility. Fertil Steril 101(3): 759-766.
  • Wu H, et al. 2018. Does vitamin E prevent asthma or wheeze in children: A systematic review and meta-analysis. Paediatr Respir Rev. 27:60-68.
  • XI Y, et al. 2022. Vitamin E concentration in breast milk in different periods of lactation: meta-analysis. Front Nutr 9: 1050011.


Sulfasalazine (Azulfidine®)

Selected References

  • Bruckmaier R, et al. 1991. Effects of alpha- and beta-adrenergic agonists in intramammary pressure and milk flow in dairy cows. J Dairy Res. 58:411-419.
  • Cottle MKW, et al. 1982. Effects of phenylephrine and sodium salicylate on maternal and fetal cardiovascular indices and blood oxygenation in sheep. Am J Obstet Gynecol. 143:170-176.
  • Gilbert-Barness E, Drut RM. 2000. Association of sympathomimetic drugs with malformations. Vet Hum Toxicol. 42:168-171.
  • Heinonen OP, et al. 1977. Birth Defects and Drugs in Pregnancy, Littleton, Publishing Sciences Group, pp 345-356, 439, 476, 491.
  • Mohta M, et al. 2022. Neonatal outcomes following phenylephrine or norepinephrine for treatment of spinal anesthesia-induced hypotension at emergency cesarean section in women with fetal compromise: a randomised controlled study. Int J of Obstet Anesthesia 49:103247.
  • Rothman KJ, et al. 1979. Exogenous hormones and other drug exposures of children with congenital heart disease. Am J Epidemiol. 109:433-439.
  • Schatz M, et al. 1997. Asthma and allergy in pregnancy. Clin Perinatol. 24(2):407-432.
  • Ugen KE, Scott WJ Jr. 1987. Reduction of uterine blood flow by phenylephrine, an alpha-adrenergic agonist, in the day 11 pregnant rat: relationship to potentiation of acetazolamide teratogenesis. Teratology. 36(1):133-141.
  • Yau W-P, et al. 2013. Use of decongestants during pregnancy and the risk of birth defects. Am J Epidemiol. 178(2):198-208.
  • Werler MM, et al. 2003. Association of vasoconstrictive exposures with risks of gastroschisis and small intestinal atresia. Epidemiology. 14(3):349-354.
  • Werler MM, et al. 2002. Maternal medication use and risks of gastroschisis and small intestinal atresia. Am J Epidemiol. 155(1):26-31.
  • Werler MM, et al. 2004. Vasoactive exposures, vascular events, and hemifacial microsomia. Birth Defects Res A Clin Mol Teratol 70(6):389-395.
  • 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. 313:347-352