This sheet is about exposure to inhaled corticosteroids (ICSs) in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.  

What are inhaled corticosteroids? 

Inhaled corticosteroids (ICSs) are medications that have been used to prevent and control the symptoms of asthma. ICSs are taken using an inhaler, pump, or nebulizer. They go directly to the lungs instead of traveling throughout the body. ICSs help control the swelling of the airways in the lungs and reduce mucus production so that asthma attacks are less likely. Some examples of ICSs are beclomethasone dipropionate (Qvar®), budesonide (Pulmicort®), fluticasone propionate (Flovent®), mometasone furoate (Asmanex®), or triamcinolone acetonide (Azmacort®).  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. For more information about asthma and pregnancy, see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/. 

ICSs are considered preferred asthma treatments during pregnancy because they usually control asthma well. They are absorbed into the body in lower amounts compared to medication taken by mouth. It is unknown how much, if any, of the medication reaches the developing pregnancy. However, research suggests that the amount is likely small.  

I take an ICS. Can it make it harder for me to get pregnant?

It is not known if ICSs can make it harder to get pregnant. 

Does taking an ICS increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. There is some data to suggest that the use of ICSs might slightly increase the chance of miscarriage. However, that chance can be different depending on the exact medication. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage.  

Does taking an ICS increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like an inhaled corticosteroid, might increase the chance of birth defects in a pregnancy. Studies that have been done on ICSs have found no overall increased chance of birth defects. 

Does taking an ICS in pregnancy increase the chance of other pregnancy-related problems?

Studies on ICSs have found no increased chance of pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

Untreated asthma can cause low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) and other pregnancy complications. A recent study showed that treating asthma with ICSs might lower the chance of preterm delivery compared to untreated asthma. It is important to work with your healthcare provider to make sure your asthma is well-controlled during pregnancy.  

Does taking an ICS in pregnancy affect future behavior or learning for the child?

It is not known if ICSs can increase the chance of behavior or learning issues for the child.  

Breastfeeding while taking an ICS:

Most ICSs have not been studied for use during breastfeeding. However, the amount of medication that passes into breast milk following inhalation is likely small and not expected to cause problems for a breastfeeding infant. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes an ICS, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if ICSs could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

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This sheet is about exposure to siponimod in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is siponimod?

Siponimod (Mayzent®) is a medication approved to treat relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. To learn more about multiple sclerosis, please see our fact sheet at: https://mothertobaby.org/fact-sheets/multiple-sclerosis/.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I am taking siponimod, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

The time it takes the body to metabolize (to process) medication is not the same for everyone. In healthy non-pregnant adults, it takes up to 8 to 10 days, on average, for most of siponimod to be gone from the body.

I take siponimod. Can it make it harder for me to get pregnant?

Studies have not been done to see if siponimod can make it harder to get pregnant.

Does taking siponimod increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. According to the product label, experimental animal studies reported an increase in pregnancy loss. Studies have not been done in human pregnancy to see if siponimod increases the chance for miscarriage.

Does taking siponimod increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. According to the product label, experimental animal studies reported an increased chance for birth defects. Studies have not been done in human pregnancy to see if siponimod increases the chance for birth defects above the background risk.

Does taking siponimod in pregnancy increase the chance of other pregnancy-related problems?

According to the product label, experimental animal studies reported a chance of low birth weight. Studies have not been done in human pregnancy to see if siponimod increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking siponimod in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if siponimod can cause behavior or learning issues for the child.

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects. Ultrasounds can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.

Breastfeeding while taking siponimod:

Siponimod has not been studied for use while breastfeeding. It is possible that small amounts of this medication might get into the breastmilk. However, these amounts can be potentially toxic for a breastfed infant. If you are taking siponimod while breastfeeding and you suspect the baby has any symptoms, such as vomiting, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes siponimod, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if siponimod could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

MotherToBaby is currently conducting a study looking at multiple sclerosis and medications used to treat it in pregnancy. If you would like to learn more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

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This sheet is about exposure to flurazepam in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is flurazepam? 

Flurazepam is a medication that has been used to treat insomnia (having a hard time falling asleep or staying asleep). Flurazepam is in a class of medications called benzodiazepines. A brand name for flurazepam is Dalmane®. 

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

Stopping flurazepam suddenly could cause withdrawal symptoms. It is not known if or how withdrawal might affect a pregnancy. It has been suggested that any reduction in flurazepam be done slowly, and under the direction of your healthcare provider.  

I take flurazepam. Can it make it harder for me to get pregnant?

Studies have not been done to see if taking flurazepam can make it harder to get pregnant.  

Does taking flurazepam increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if flurazepam can increase the chance of miscarriage. 

Does taking flurazepam increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like flurazepam, might increase the chance of birth defects in a pregnancy.  

Studies have not been done in humans to see if flurazepam can increase the chance of birth defects. Animal studies did not find a higher chance of birth defects with exposure to flurazepam.  

Does taking flurazepam in pregnancy increase the chance of other pregnancy-related problems? 

Studies have not been done to see if flurazepam can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

I need to take flurazepam throughout my entire pregnancy. Will it cause symptoms in my baby after birth? 

The use of flurazepam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. If flurazepam is used at the end of pregnancy, the baby can be monitored for “floppy infant syndrome” (poor muscle tone) and trouble feeding. Not all babies exposed to flurazepam will have symptoms. It is important that your healthcare providers know you are taking flurazepam so that if symptoms occur your baby can get the care that is best for them. 

Does taking flurazepam in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if flurazepam can increase the chance of behavior or learning issues for the child.  

Breastfeeding while taking flurazepam:

Flurazepam has not been studied for use while breastfeeding. There is a report of drowsiness (being very sleepy) in an infant who was exposed to flurazepam and 3 other medications through breastmilk. It is not known if the flurazepam, another medication, the combination of medications, or other factors caused the baby to be too sleepy.  

The product label for flurazepam recommends people who are breastfeeding not use this medication. However, the benefit of using flurazepam might outweigh possible risks. If you take flurazepam while breastfeeding and suspect the baby has any symptoms (such as drowsiness, poor feeding, or poor weight gain), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes flurazepam, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if flurazepam could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.  

This sheet is about exposure to temazepam in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is temazepam? 

Temazepam is a medication that has been used to treat insomnia (having a hard time falling asleep or staying asleep). Temazepam is in a class of medications called benzodiazepines. It is sold under the brand name Restoril®. 

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping all at once. Stopping this medication suddenly can cause some people to have withdrawal symptoms. It is not known what effects, if any, withdrawal could have on a pregnancy. 

I take temazepam. Can it make it harder for me to get pregnant?

It is not known if using temazepam could make it harder to get pregnant.  

Does taking temazepam increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. One study suggested that temazepam might increase the chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage. 

Does taking temazepam increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like temazepam, might increase the chance of birth defects in a pregnancy. 

A study of 379 children exposed to temazepam in the first trimester of pregnancy did not find a higher chance of birth defects. 

Does taking temazepam in pregnancy increase the chance of other pregnancy-related problems?

Studies have not been done to see if temazepam can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

I need to take temazepam throughout my entire pregnancy. Will it cause symptoms in my baby after birth? 

The use of benzodiazepines during pregnancy near the time of delivery could cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms can include irritability, crying, sleep disturbances, tremors, jitteriness, trouble breathing, or muscle weakness. Not all babies exposed to benzodiazepines will have these symptoms. It is not known if the use of temazepam in pregnancy can cause these symptoms in a newborn. It is important that your healthcare providers know you are taking temazepam so that if symptoms occur your baby can get the care that is best for them. 

Can I take my benzodiazepine with diphenhydramine?

A single human report and animal data have suggested that the combination of temazepam and diphenhydramine (Benadryl®) might increase the chance for stillbirth or for infant death shortly after birth. People taking temazepam should talk with their healthcare provider before taking diphenhydramine during their pregnancy. MotherToBaby has a fact sheet on diphenhydramine here: https://mothertobaby.org/fact-sheets/diphenhydramine-pregnancy/.  

Does taking temazepam in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if temazepam can increase the chance of behavior or learning issues for the child.  

Breastfeeding while taking temazepam:

Temazepam has not been well studied for use while breastfeeding. Only small amounts of temazepam get into breast milk. No side effects were reported in approximately 10 infants who were exposed to temazepam through breast milk. Children exposed to temazepam through breastfeeding should be watched for excessive drowsiness (being too sleepy). If you suspect the baby has any symptoms (such as being very sleepy, poor weight gain, low muscle tone [floppiness], or slowed breathing), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes temazepam, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if temazepam could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.   

This sheet is about exposure to abatacept in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is abatacept?

Abatacept is a medication that has been used to treat rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), and psoriatic arthritis (PsA). It has also been used to treat COVID-19 in some hospitalized patients. It works by lowering the activity of T cells (part of the body’s immune system) to help reduce inflammation or swelling. It can be given through a vein in the arm (infusion) or by a shot under the skin. It is sold under the brand name Orencia®.

To learn more about rheumatoid arthritis and psoriatic arthritis, please see the MotherToBaby fact sheets at https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/ and https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy/. To learn more about COVID-19, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/covid-19/.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I am taking abatacept, but I would like to stop taking it before becoming pregnant. How long does the drug stay in my body?

People eliminate medications at different rates. In healthy adults, it takes up to 10 weeks, on average, for most of the abatacept to be gone from the body.

I take abatacept. Can it make it harder for me to get pregnant?

Studies have not been done to see if abatacept can make it harder to get pregnant.

Does taking abatacept increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. The manufacturer did not find a higher chance of miscarriage among 151 women who used abatacept in pregnancy.

Does taking abatacept increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Animal studies done by the manufacturer did not show an increased chance of birth defects when abatacept was used in pregnancy. Abatacept has not been well studied in human pregnancy. However, published information collected on over 200 pregnancies did not find a pattern of birth defects associated with abatacept use in pregnancy. There is also a case report of a woman with active rheumatoid arthritis who became pregnant while using abatacept, with her last dose just after the fourth week of pregnancy. She delivered a healthy infant that was also reported to be doing well at a 3.5-year follow-up visit. Based on limited information, there is probably not an increased risk for birth defects with abatacept.

Does taking abatacept in pregnancy increase the chance of other pregnancy related problems?

Studies have not been done to see if abatacept increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking abatacept in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if abatacept can cause behavior or learning issues for the child.

Breastfeeding while taking abatacept:

Abatacept has not been well studied for use while breastfeeding. Since it is a large molecule, it is thought to be unlikely to enter the milk in high amounts. Also, abatacept is poorly absorbed from the gut, so it is unlikely that any of the medication the baby swallowed in the breast milk would be absorbed into the baby’s system. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a man takes abatacept, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if abatacept could affect a man’s fertility (ability to get a woman pregnant). The manufacturer reported on 10 men who were taking abatacept when their partners became pregnant and did not find a greater chance for birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures (https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/).

MotherToBaby is currently conducting a study looking at abatacept and other medications used to treat autoimmune diseases in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-a-study-form/.

Please click here for references.