This sheet is about exposure to vitamin E 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 vitamin E?

Vitamin E is an essential vitamin that is used by the body as an antioxidant (protects cells from damage) and helps the immune system fight infections. Essential vitamins are nutrients that the body cannot make, so people need to get them from other sources. Vitamin E can be found in foods such as seeds, nuts, vegetable oils, leafy vegetables, and cereals that have had vitamin E added to them. Vitamin E is also available as a dietary supplement. Vitamin E deficiency (not having enough vitamin E in the body) can cause problems with the muscles, nerves, and immune system.

If you have been prescribed vitamin E by your healthcare providers, talk with them before making changes to how you take your supplement. Your healthcare providers can talk with you about the benefits of maintaining your nutrient levels and the risks of low nutrients during pregnancy. It is not recommended to take more than the recommended dietary allowance (RDA) of vitamin E unless you are doing so under the care of your healthcare provider.

Talk with your healthcare providers about all supplements/vitamins that you take. Have the bottles or photos of the labels with you so that all ingredients and amounts can be reviewed. Herbal supplements are typically not recommended for use during pregnancy. For more information on herbal products please see our fact sheet at: https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/.

How much vitamin E is needed by women who are pregnant?

The Recommended Dietary Allowance (RDA) is the amount people should aim to get each day. The Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is not expected to increase health risks for most people in the general population.

It is not recommended to take more than the RDA in a day unless it has been prescribed by your healthcare provider.

When looking at daily intake, remember to count amounts from foods, drinks, and from supplements. There are resources available online that list amounts of vitamin E typically found in foods, such as the United States Department of Agriculture (USDA) National Nutrient Database, found here: https://ods.od.nih.gov/pubs/usdandb/VitaminE-Food.pdf. Labels on supplements will list the amount of vitamin E in the product. Be sure to talk with your healthcare providers about your specific nutritional needs before, during, and after pregnancy.

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

Taking vitamin E at the RDA and staying below the UL is not expected to make it harder to get pregnant.

Does taking vitamin E increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. There are no studies that suggest that taking more than the RDA, but less than the UL, of vitamin E or having too little vitamin E can increase the chance of miscarriage. Studies have not been done to see if taking more than the UL of vitamin E can increase the chance of miscarriage.

Does taking vitamin E 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. Taking vitamin E at the RDA and staying below the UL is not expected to increase the chance of birth defects.

One study reported an increased chance of heart defects when women took between 14.9 and 33.8 mg daily during pregnancy (more than the RDA but less than the UL). Another study reported an increased chance of heart defects when the woman who was pregnant did not get the RDA of vitamin E. This is not enough information to draw conclusions from these reports. There is no proven relationship between the amount of vitamin E taken and an increased chance of birth defects.

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

It is not known if taking too much or too little vitamin E can cause other 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). One study reported that mothers with blood concentration of vitamin E in the high end of the of the normal range had newborns who were large for gestational age (LGA) (weighing more than most other newborns) compared to mothers who had lower vitamin E levels that were still within the normal range. One study is not enough to make a conclusion about vitamin E having an effect on a newborn’s size.

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

Taking vitamin E at the RDA and staying below the UL is not expected to affect future behavior or learning for the child. Studies in humans have not been done to see if too much or too little vitamin E increases the chance for behavior or learning issues.

Breastfeeding while taking vitamin E:

Vitamin E is a normal part of breast milk. Women who are breastfeeding should continue to get the daily recommended amount of vitamin E unless otherwise directed by their healthcare provider. The RDA for breastfeeding is higher than for pregnancy. Refer to the chart above for the RDA and UL while breastfeeding.

Women who are breastfeeding should talk to their healthcare provider and their child’s pediatrician about their nutritional needs before, during, and after breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

It is not known if too much vitamin E in could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. Men with vitamin E deficiency (blood levels of vitamin E less than 4 mg/L) might make less sperm, which could affect the ability to get a woman pregnant. 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 insulin glargine 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 insulin glargine? 

Insulin glargine is a long-acting medication used to treat type 1 and type 2 diabetes. It is an artificial form of insulin that works by replacing insulin that would usually be made by the body. Some brand names are Basaglar®, Lantus®, Semglee®, and Toujeo®.  

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. 

Women who are using insulin to manage their diabetes might need to adjust the amount of medication they take as the pregnancy goes on. Diabetes that is uncontrolled or not well controlled in pregnancy can increase the chance of miscarriage, birth defects, pregnancy complications, and stillbirth. MotherToBaby has a fact sheet on type 1 and type 2 diabetes here: https://mothertobaby.org/fact-sheets/type-1-and-type-2-diabetes/ and on gestational diabetes here: https://mothertobaby.org/fact-sheets/diabetes-pregnancy/.    

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

Taking insulin glargine is not expected to make it harder to get pregnant.  

Does taking insulin glargine increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. In over 800 reports of women taking insulin glargine during pregnancy, an increased chance of miscarriage was not reported.  

Does taking insulin glargine 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 insulin glargine, might increase the chance of birth defects in a pregnancy. Taking insulin glargine is not expected to increase the chance of birth defects. In over 800 reports of women taking insulin glargine throughout pregnancy, no increase in birth defects was reported. In studies that compared the rates of birth defects in pregnancies exposed to insulin glargine and pregnancies exposed to other medications to control type 1 and type 2 diabetes, no increased chance of birth defects above the background risk was reported.  

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

It is unclear if taking insulin glargine can increase the chance of other 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).  

One study looked to see if different forms of insulin to treat type 1 diabetes during pregnancy might affect the growth of the fetus. Looking at the pregnancies of those using insulin glargine versus a different form of insulin (human-made insulin), babies being small for gestational age (SGA) (smaller in size compared to babies of the same age) was reported more often. However, when looking at growth compared to the pregnancies treated with any insulin medication for type 1 diabetes, the chance for SGA was not increased.   

Poorly controlled diabetes increases the chance of health and pregnancy complications. It is important that your condition is well-treated before, during, and after pregnancy.  

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

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

Breastfeeding while taking insulin glargine: 

Insulin glargine is a normal part of breastmilk and using it while breastfeeding is not expected to cause problems for the breastfed infant. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Studies have not been done to see if insulin glargine could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects above the background risk. In general, exposures that men 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 vilazodone 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 vilazodone?

Vilazodone is a medication that has been used to treat major depressive disorder. A brand name is Viibryd®.

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.

Research has shown that when depression is left untreated during pregnancy, there could be an increased chance for pregnancy complications. For more information, please see our fact sheet on depression at https://mothertobaby.org/fact-sheets/depression-pregnancy/.

Some women may have a return of their symptoms (relapse) if they stop this medication 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 if or how withdrawal might affect a pregnancy.

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

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

Does taking vilazodone increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if vilazodone increases the chance for miscarriage. However, depression itself might increase the chance for miscarriage.

Does taking vilazodone 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 did not find an increased chance of birth defects. We have been unable to locate studies on the use of vilazodone in human pregnancies.

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

Studies have not been done to see if vilazodone can cause other 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 vilazodone throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

It is not known if the use of vilazodone during pregnancy can cause withdrawal symptoms in a baby after birth. The use of other antidepressants during pregnancy has been associated with temporary symptoms in some newborns after birth. These symptoms are sometimes referred to as withdrawal. Symptoms may include jitteriness, increased muscle tone, irritability, changes in sleep patterns, tremors, trouble eating, and trouble breathing. These symptoms are usually mild and go away on their own. Some babies may need to stay in a special care nursery for several days. Not all babies exposed to an antidepressant will have these symptoms. It is important that your healthcare providers know you are taking vilazodone so that if symptoms occur your baby can get the best care.

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

Studies have not been done to see if vilazodone use in pregnancy can cause behavior or learning issues for the child.

Breastfeeding while taking vilazodone:

It is not known if vilazodone gets into breast milk or causes side effects for a baby who receives the milk. The benefit of continuing vilazodone while breastfeeding may outweigh the risks of an untreated mental health condition or the risks of not breastfeeding. Your healthcare provider can talk with you about vilazodone and what treatment is best for you.  Be sure to talk to your healthcare provider about all of your breastfeeding questions.

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

Studies have not been done to see if vilazodone could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. In the clinical trials for this medication, adverse sexual functioning (lack of orgasm and reduced sex drive) was noted in some cases. This could reduce fertility for some men.  Also, men with mental health conditions, such as depression, may have lower fertility, which might make it harder for them to get a woman pregnant. In general, exposures that fathers or sperm donors have are unlikely to increase the 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 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/. 

Please click here for references.

This sheet is about exposure to fluconazole 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 fluconazole?

Fluconazole is a medication that has been used to treat yeast and fungal infections. It can be taken orally (by mouth), injected (by shot), or given by IV (into a vein). It is mostly used as a single oral dose of 150 milligrams (mg) to treat vaginal yeast infections. For severe fungal infections involving the whole body, higher IV doses of up to 800 mg daily have been used. Fluconazole is sold under the brand name Diflucan®.  

The product label for fluconazole recommends women who are pregnant not use this medication except in cases of severe or potentially life-threatening fungal infections. However, the benefit of using fluconazole might outweigh possible risks. Your healthcare providers can talk with you about using fluconazole and what treatment is best for you.  

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

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

Does taking fluconazole increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies on the use of fluconazole and miscarriage have mixed results.  

One study included almost 600 women who filled prescriptions for oral fluconazole in pregnancy. The study suggested an increased chance of miscarriage with any dose of fluconazole during early pregnancy. A second study also looked at pregnancies with a filled prescription for oral fluconazole. The study suggested a higher chance of miscarriage with a single dose of fluconazole for vaginal yeast infection between weeks 7 and 22 of pregnancy. This study has flaws that make it hard to confirm that the chance of miscarriage was truly higher in this group. Also, studies based on prescriptions/prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors (such as age, health, other exposures) are the cause of a miscarriage. 

Two studies involving over 500 pregnancies with use of low-dose oral fluconazole in the months before or during the pregnancy did not find an increased chance of miscarriage. The U.S. Food and Drug Administration (FDA) made a statement in October 2019 saying that available studies do not provide definite evidence of an increased chance of miscarriage with a single 150 mg dose of oral fluconazole.  

Does taking fluconazole 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 fluconazole, might increase the chance of birth defects in a pregnancy. 

Studies on the use of fluconazole and birth defects have mixed results. It is unlikely that the use of a single 150 mg dose of oral fluconazole during pregnancy would increase the chance of birth defects. Some studies suggest a small increase in the chance of heart defects or other birth defects with doses above 150 mg up to 300 mg during the first trimester. It is not always clear in these studies if the medication was given in a single dose or in multiple doses at different times. Other studies do not report an increased chance of birth defects with any dose up to 300 mg.  

The use of high-dose fluconazole for many weeks might be associated with a higher chance of birth defects. A pattern of birth defects of the head, face, bones, and heart has been reported in five children born to four women who took high doses (400 to 1200 mg per day) of fluconazole for many weeks during pregnancy to treat severe fungal infections. These cases alone cannot prove that fluconazole caused these problems, but the similar pattern of birth defects in these children has raised concern that the high doses of fluconazole might have been the cause.  

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

Studies have not found an increased chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) following a single dose of fluconazole. Studies have not found an increased chance of stillbirth in pregnancies exposed to fluconazole.  

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

Studies have not been done to see if fluconazole can increase the chance of 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, such as heart defects. Ultrasound can also be used to watch 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 fluconazole:

Fluconazole passes into breast milk in small amounts. These amounts are estimated to be less than the dose that could be given directly to an infant to treat an infection. Taking a single dose of fluconazole while breastfeeding is unlikely to cause problems for the breastfed infant. If you suspect the baby has any symptoms, such as stomach upset or diarrhea, contact the child’s healthcare provider. 

If a person who is breastfeeding has a yeast infection of the breast, the infant might also have oral thrush (a yeast infection in the mouth). If the child does have oral thrush, they will need their own medical treatment because the amount of fluconazole that passes into the breast milk is not enough to treat the child’s infection. If you suspect the baby has oral thrush or other symptoms, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done in humans to see if fluconazole could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. One study in laboratory animals found lowered sperm count while the animal was exposed to fluconazole. Sperm counts returned to normal two months after stopping treatment. In general, exposures that fathers or sperm donors 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.