Asthma is a common medical condition affecting women of reproductive age, yet many of the medications used to treat it are not well-studied for their safety in pregnancy and lactation, leading many asthma sufferers to discontinue their medications when they are expecting or nursing. Since uncontrolled asthma can lead to poor outcomes for both mom and baby, national experts led by Dr. Christina Chambers, one of our MotherToBaby specialists based at the University of California San Diego and an investigator for the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS), have come together to detail an action plan for filling the information gaps about asthma medication safety in pregnancy and lactation.

Published online this week in The Journal of Allergy and Clinical Immunology, the action plan describes the proceedings from a workshop conducted in November 2019 and supported by the National Heart, Lung, and Blood Institute and the Office of Research on Women’s Health in the Office of the Director of the National Institutes of Health and the U.S. Food and Drug Administration Office of Women’s Health. The workshop assembled key stakeholders who were tasked with prioritizing, strategizing and mobilizing action steps on gaps in knowledge regarding asthma medication safety in pregnancy and lactation. The overarching goal of the workshop was to identify approaches that could be applied broadly to fill gaps in data about the safety of all medications and vaccines in pregnancy and lactation.

As a result of the workshop, a multi-stakeholder consortium on asthma medications in pregnancy and lactation has been developed. In order to address the evidence gaps and aid in populating medication labels with data that health providers can use to inform clinical decision making, the consortium developed a plan to systematically obtain necessary data in the most efficient and timely manner.  The consortium also recommended the development of guidelines for the evaluation and management of asthma during pregnancy and lactation that adhere to the standards developed by the National Academy of Medicine, which would not only offer recommendations for patients, caregivers, and health providers at the point-of-care but also highlight specific evidence gaps that warrant further research. According to Chambers, “the need for high quality information regarding medication and vaccine safety in pregnancy and lactation is great – implementation of the recommendations stemming from this workshop will be a major step forward in addressing this health disparity.”

In partnership with VAMPSS, MotherToBaby conducts observational pregnancy studies to evaluate the safety of medications used to treat asthma and other health conditions. MotherToBaby Pregnancy Studies accept both healthcare provider referrals as well as patient self-referrals. To learn more, visit: MotherToBaby.org/Studies.

Read the Abstract

March 23, 2020

LA JOLLA, CA –A new study conducted by birth defects research experts from the non-profit Organization of Teratology Information Specialists (OTIS) launches to examine the short and long-term effects of the novel COVID-19 virus in pregnancy and breastfeeding. The observational study will consist of phone calls over the course of volunteers’ pregnancies and post-delivery, and/or breastmilk samples, as well as a release of medical records related to the pregnancy and the infant’s development.

OTIS is the scientific non-profit society that provides the no-cost MotherToBaby information service and enrolls women through the MotherToBaby Pregnancy Studies.

“Women and their health care providers need answers as quickly as possible regarding the effects of COVID-19 during pregnancy and while breastfeeding,” said the Principal Investigator, Christina Chambers, PhD, MPH, OTIS/MotherToBaby president and professor of pediatrics at UC San Diego (pictured right). “We know that pregnant and breastfeeding moms are contracting COVID-19, but the fact of the matter is that we know very little about its short and long-term effects on a developing baby,” she added. “We hope pregnant women see the importance in helping the world understand this novel virus and consider volunteering for the study.”

The study is open to pregnant and breastfeeding women in the United States and Canada with known or suspected COVID-19 infection. The MotherToBaby Pregnancy Studies Research Center is located at the University of California San Diego.

Pregnant women and breastfeeding mothers can enroll in the study at the following link https://mothertobaby.org/join-study/ or by calling MotherToBaby Pregnancy Studies at (877) 311-8972. Learn more about the ongoing observational study at https://mothertobaby.org/ongoing-study/coronavirus-covid-19/.

Health care providers can refer pregnant and breastfeeding patients with known or suspected COVID-19 infection at the following link https://mothertobaby.org/healthcare-professional-referral-form/ or by calling MotherToBaby Pregnancy Studies at (877) 311-8972.

More about OTIS and MotherToBaby

The Organization of Teratology Information Specialists (OTIS) is a professional scientific society made up of individuals engaged in assessing and evaluating risks to pregnancy and breastfeeding from environmental exposures. Members include, but are not limited to, specialists in the fields of: obstetrics and gynecology, pediatrics, genetics, dysmorphology, perinatal epidemiology, teratology, behavioral teratology, pharmacy, genetic counseling, nursing, midwifery, maternal and child health, public health, and includes experts that provide MotherToBaby services and researchers that conduct MotherToBaby Pregnancy Studies. MotherToBaby is a suggested resource by many federal agencies including the Centers for Disease Control and Prevention (CDC). To learn more about ongoing MotherToBaby Pregnancy Studies, call (877) 311-8972, email MotherToBaby@ucsd.edu or visit www.MotherToBaby.org.

The study launched March 23, 2020. Interviews with Christina Chambers, PhD, MPH are now being scheduled. Interested media, please call 619-368-3259 or email nchavez@mothertobaby.org.

World-Renowned UC San Diego Epidemiologist Leads Groundbreaking Study

SAN DIEGO, CA – Recruitment is underway for a groundbreaking new study on the treatment of lupus during pregnancy.  The observational research, led by world-renowned UC San Diego epidemiologist Christina Chambers, PhD, MPH, is the first of its kind for the non-profit MotherToBaby, a CDC-recommended organization that provides evidence-based information on medications, diseases, vaccines, herbal supplements and more during pregnancy and breastfeeding. 

The study will recruit 400 pregnant people over a five-year period to evaluate use of the lupus drug Benlysta® (belimumab) in pregnancy. Benlysta® is used to treat the most common type of lupus, systemic lupus erythematosus (SLE), as well as lupus nephritis. Currently, there is limited information on the drug’s use in pregnancy.

The study will be MotherToBaby’s first to focus on a treatment specifically for lupus, and participants will be enrolled into the MotherToBaby Pregnancy Studies research program. Chambers, who is the lead investigator for MotherToBaby Pregnancy Studies, Co-Director of the Center for Better Beginnings, and Chief of the Environmental Science and Health Division in the UC San Diego Department of Pediatrics, noted that, “lupus can raise the risk of pregnancy complications, so it’s important for both the mom and her developing baby that this condition be well-managed during pregnancy. So, when treatments for lupus like belimumab are available, we want to do our best to gather information about those pregnancies where this medication has been used.”

The study is enrolling pregnant and recently pregnant people with exposure to Benlysta® and will provide critical information on the use of this medication during pregnancy. Participants will not be asked to change any part of their health care routine, including medications, nor will they be asked to travel.

More about MotherToBaby Pregnancy Studies

MotherToBaby Pregnancy Studies are conducted by the non-profit Organization of Teratology Information Specialists (OTIS) and coordinated at the Center for Better Beginnings at UC San Diego. OTIS is a professional scientific society made up of individuals engaged in assessing and evaluating risks to pregnancy and breastfeeding from environmental exposures. Members include, but are not limited to, specialists in the fields of obstetrics and gynecology, pediatrics, genetics, dysmorphology, perinatal epidemiology, teratology, behavioral teratology, pharmacy, genetic counseling, nursing, midwifery, maternal and child health, public health, and include experts that provide MotherToBaby services and researchers that conduct MotherToBaby Pregnancy Studies.

MotherToBaby is a suggested resource by many federal agencies including the Centers for Disease Control and Prevention (CDC). MotherToBaby is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,000,000 with zero percentage financed with non-governmental sources. The contents of this release are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government. To learn more about MotherToBaby and OTIS, please visit MotherToBaby.org.

Media Contact: Nicole Chavez, nchavez@mothertobaby.org, 619-368-3259

We Can Help You and Your Pregnant and Lactating Patients Make Informed Decisions

MotherToBaby supports midwives as they care for their patients during preconception planning, pregnancy, and delivery. People who are pregnant often have a litany of questions about how best to ensure a healthy pregnancy and healthy baby – and some of those questions may center on how a person’s exposures could impact their developing baby during pregnancy or while breastfeeding. Examples of such exposures could include but are not limited to medications that a person may need to take, foods or beverages they consume, substances they use, infections they may contract, or vaccines they may need to receive. Exposures are different for every person, and the bottom line is we all want what is healthy for both parent and baby.

We’re the experts on evaluating the effects of exposures during pregnancy and breastfeeding. Our resources are no-cost and patient-friendly, and will help you understand the benefit or risk of an exposure for the person who is pregnant and their baby. No matter if your patient has a preexisting illness, a medical problem that requires diagnostics or medication treatment, or has questions about substance use, we are here to provide you with evidence-based information on exposures during pregnancy and lactation.

Midwives are ideally positioned to prevent or limit toxic exposure in [people who are pregnant], fetuses, and infants.

— American College of Nurse Midwives: The Effect of Environmental Toxins on Reproductive and Developmental Health, 2015

Explore how we can help you and your pregnant and breastfeeding patients by providing no-cost exposure risk assessments, patient education materials, observational studies to monitor pregnancy outcomes, and more.

By Lori Wolfe, CGC, MotherToBaby North Texas

Nicole called me in tears. She had been trying to become pregnant for the past nine months and was not having any luck. She asked if it could be due to being overweight. As I talked with Nicole, I found out she is about 100 pounds over a healthy weight for her height. As a MotherToBaby specialist, I often talk with women who are trying to become pregnant. It just so happened this question came along as I was reviewing tips for January’s Birth Defects Prevention Month. Tip #4 is: Before you get pregnant, try to reach a healthy weight.

I explained to Nicole that studies have shown that women who are overweight can have a number of different problems trying to become pregnant, but she shouldn’t worry. Many of the problems outlined below can be reversed when healthy eating and exercise are incorporated into her routine. Some of the issues which can result from being overweight while trying to conceive include:

1. An increased chance of having irregular or absent periods, making it difficult to conceive
2. Producing too much estrogen, which can also make it harder to get pregnant
3. An increased chance of having complications during fertility treatments
4. Having polycystic ovary syndrome , a hormonal disorder that is a major contributor to infertility in women of child bearing age

Once they get pregnant, women who are overweight or obese are at a higher risk for the following complications during pregnancy:

• Miscarriage
• Heart disease
• Increased chance for a birth defect in the baby
• Gestational diabetes
• High blood pressure and preeclampsia (a dangerous kind of high blood pressure that can happen during or right after pregnancy))
• Cesarean birth

After discussing all of this with Nicole, her next question to me was what can she do to reduce these possible risks? Fortunately, most women with overweight can expect to have a healthy pregnancy. I explained to Nicole that it is best to talk with her doctor and try to lose weight before becoming pregnant. Losing weight once you are pregnant is not advised. Start now to eat a healthy diet and exercise regularly before pregnancy, and keep this up once you become pregnant.

Healthy eating includes folic acid
Another important Birth Defects Prevention Month tip is Tip #1: Be sure to take 400 micrograms (mcg) of folic acid every day.

We all need folic acid every day in our bodies to help make new cells. Folic acid is a synthetic form of Vitamin B9, also known as folate. It is very important to take enough folic acid just before and during pregnancy. Many studies have shown that taking 400 mcg of folic acid before and early in pregnancy every day reduces the chance that a baby will have serious birth defects of the spine and brain, called neural tube defects (NTDs). This is even more important in women who are overweight as their body requires more folic acid.

Nicole was relieved to hear that her weight didn’t have to be an obstacle and that there were things she could do to increase her chance of becoming pregnant and having a healthy baby. Losing weight, eating healthy foods and daily exercise can increase her chances of becoming pregnant and can decrease her chances of miscarriage, birth defects and other pregnancy problems. She said she will call her health care provider right away to schedule an appointment to talk about everything and was excited that the future looked brighter to one day become a mom!

Lori Wolfe, CGC, is a board certified Genetic Counselor and the Director of MotherToBaby’s North Texas affiliate. MotherToBaby aims to educate women about medications and more during pregnancy and breastfeeding. Along with answering women’s and health professionals’ questions regarding exposures during pregnancy/breastfeeding via MotherToBaby’s toll-free number, text line and by email, Wolfe also teaches at the University of North Texas, provides educational talks regarding pregnancy health in community clinics and high schools.

About MotherToBaby
MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.