This sheet is about exposure to e-cigarettes 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 e-cigarettes?

Electronic cigarettes, or e-cigarettes, are battery-operated devices that heat a liquid solution into a fine spray (aerosol) that you inhale (breathe in), like you would inhale tobacco smoke from a traditional cigarette. E-cigarettes are known by many different names, such as “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).” Using e-cigarettes is sometimes referred to as “vaping.”  

The solutions in e-cigarettes can include chemicals such as nicotine, propylene glycol, ethylene glycol, polyethylene glycol, diacetyl, and/or glycerol, and heavy metals such as nickel, tin, and/or lead. Artificial flavorings might also be added. E-cigarettes can have contaminants that could pose a risk to both the health of the person using the e-cigarette and a pregnancy.  

There are only a few studies that look at e-cigarette use while pregnant. The information is limited because not all e-cigarettes are the same and many have different ingredients. While sometimes there is information about individual ingredients, often there is no information on the effect of those ingredients in combination. That means it is not clear what effect, if any, the ingredients can have on a pregnancy. 

Is the level of nicotine in e-cigarettes the same as traditional cigarettes?

It is not clear how much nicotine is in e-cigarettes, in part because they are not well regulated. Some labels say they have no nicotine but do, and other labels claim to have nicotine when they do not. There may be more nicotine in some brands of e-cigarettes than in regular cigarettes. Even though e-cigarettes are advertised to help people quit smoking, studies have not proved that they effective. Using e-cigarettes during pregnancy is not recommended. 

I use e-cigarettes. Can they make it harder for me to get pregnant? 

Studies have not been done to see if exposure to e-cigarettes in humans can make it harder to get pregnant. There are animal studies that show that nicotine and some of the flavoring ingredients found in e-cigarettes can lead to changes in the ovaries which can affect fertility (ability to get pregnant).  

Does using e-cigarettes increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. One study that looked at exposure to e-cigarettes during pregnancy showed an increased chance of miscarriage. Other studies on traditional cigarettes that include nicotine have been found to increase the chance of miscarriage. Our fact sheet on tobacco cigarettes can be found at https://mothertobaby.org/fact-sheets/cigarette-smoking-pregnancy/.  

Does using e-cigarettes 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 e-cigarettes, might increase the chance of birth defects in a pregnancy.  

It is not known if e-cigarettes can increase the chance of birth defects. Animal studies suggest that exposure to e-cigarettes during pregnancy can impact fetal development. Traditional cigarettes that have nicotine might increase the chance for cleft lip and/or palate (opening in the lip and/or roof of the mouth), and problems with the respiratory and digestive systems. 

Does the use of e-cigarettes in pregnancy increase the chance of other pregnancy-related problems?

Studies have shown that people who used e-cigarettes during pregnancy have an increased chance of preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), and poor growth. Another study suggests that using e-cigarettes before pregnancy can increase the risk for gestational hypertension (high blood pressure during pregnancy).  

Does using e-cigarettes in pregnancy affect future behavior or learning for the child?  

It is not known if the use of e-cigarettes can increase the chance of learning or behavior issues for the child. Some studies have linked traditional cigarettes with nicotine to higher chances for attention deficit hyperactivity disorder (ADHD) and learning disabilities.  

What resources or treatments are available to help me to quit e-cigarettes and tobacco cigarettes during pregnancy?

Talk with your healthcare provider about quitting. There is also free advice, support, and referrals with the Smoker’s Quitline at 1-800-QUIT-NOW (1-800-784-8669). While these resources focus on tobacco cigarettes, nicotine is the addictive chemical in both e-cigarettes and tobacco cigarettes, so they can still provide help regarding e-cigarettes. 

Breastfeeding while using e-cigarettes:

The use of e-cigarettes during breastfeeding has not been studied and is not recommended while breastfeeding. Nicotine passes into breast milk. Studies have shown that infant heart rate and blood pressure changes have been associated with higher nicotine concentrations in milk. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man uses e-cigarettes, could it affect fertility or increase the chance of birth defects?

The use of e-cigarettes can lower the number of sperm, which can affect men’s fertility (ability to get a partner pregnant). It is not known if e-cigarette use could increase the chance of birth defects in a partner’s pregnancy. For more general information about paternal exposures, please see our fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.  

This sheet is about exposure to carvedilol 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 carvedilol? 

Carvedilol is a medication that has been used to treat high blood pressure (hypertension) and heart failure. It helps your heart pump blood better and lowers blood pressure. Carvedilol is sold under the brand names Coreg® and Coreg CR®.   

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. 

During pregnancy, the heart works harder because the heart rate and blood volume increase. For women with heart conditions or high blood pressure, these changes may worsen symptoms and increase the risk of complications such as miscarriage, stillbirth, placental abruption, preterm birth (before 37 weeks), fetal growth restriction, and preeclampsia. Preeclampsia can lead to seizures (eclampsia) and other serious health problems. The American College of Obstetricians and Gynecologists (ACOG) recommends treatment when the top blood pressure number (systolic) is 160 mm Hg or higher, the bottom number (diastolic) is 110 mm Hg or higher, or both. Regular prenatal care and blood pressure management are important before, during, and after pregnancy.  

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

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

In experimental animal studies, there were no effects on fertility (ability to get pregnant) when animals were given 10 times more carvedilol than would be given to humans.  

Does taking carvedilol increase the chance of miscarriage? 

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

In experimental animal studies, there was an increased chance of miscarriage when animals were given 25-50 times more carvedilol than would be given to humans. Since the medication was given to animals in such high amounts, it was not given to treat a medical condition, and because animals can react differently than humans do, we cannot draw conclusions on the use of carvedilol in animals and the chance of miscarriage in humans.  

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

It is not known if carvedilol can increase the chance of birth defects. In one study, filling a prescription for beta-blockers (the class of medications carvedilol belongs to) was not associated with an increased chance of birth defects. Studies based on filled prescriptions cannot tell if a person took the medication.  

In three other studies, taking beta-blockers (including carvedilol) during pregnancy was associated with an increased chance of heart defects. However, some of these studies did not consider other factors that could influence the chance of heart defects, including the underlying health condition being treated or a family history of heart defects.  

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

It is not known if carvedilol 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). 

In one study, there was no difference in the growth of fetuses exposed to beta-blockers (including carvedilol) compared to those not exposed to beta-blockers. Two studies have reported an increased chance of hypoglycemia (low blood sugar) in infants exposed to beta blockers during pregnancy. However, there were limitations to the methods used in these studies, which made it hard to draw conclusions based on the results.   

The product label for carvedilol states that women with hypertension that are treated with beta-blockers might have a higher chance of having a child born with hypotension (low blood pressure), bradycardia (slower heart rate), hypoglycemia, and problems breathing. Not all babies exposed to carvedilol will have these symptoms. Your healthcare providers can talk with you about using carvedilol and what treatment is best for you. It is important that your healthcare providers know you are taking carvedilol so that if symptoms occur, your baby can get the care that is best for them. 

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

Studies have not been done to see if carvedilol 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 carvedilol: 

Information on the use of carvedilol in breastfeeding is limited. It is expected to pass into breast milk in small amounts. In a study looking at other beta-blockers (not including carvedilol) during breastfeeding, no increased chance of side effects was reported. If you suspect the baby has any symptoms (such as irritability, low energy levels, or being too sleepy), contact your child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if carvedilol could affect men’s fertility (ability to make healthy sperm) or increase the chance of 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 at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.  

This sheet is about exposure to mesalamine 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 mesalamine? 

Mesalamine (also known as mesalazine) is an anti-inflammatory medication (reduces inflammation or swelling) that has been used to treat ulcerative colitis and inflammatory bowel disease (IBD). It belongs to a class of medications called 5-aminosalicylic acids (5-ASA). Mesalamine has several brand names and can be taken in different ways. Some brands taken by mouth (orally) include Apriso®, Asacol®, Delzicol®, Lialda®, and Pentasa®. Other brands are used rectally (as a suppository or enema), such as Canasa®, Rowasa®, and Pentasa®. 

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. When left untreated, IBD increases the risk of complications for both the woman who is pregnant and the fetus. 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 IBD, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/inflammatory-bowel-disease-pregnancy/ 

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

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

Does taking mesalamine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. One study of 146 women who used mesalamine in the first trimester did not find a higher chance of miscarriage.  

Does taking mesalamine 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 mesalamine, might increase the chance of birth defects in a pregnancy. Several studies of pregnant women who took mesalamine in the first trimester have not found an increased chance of birth defects.  

One study looked at the medical records of more than 2,000 infants who were reported to have been exposed to mesalamine during the first trimester of pregnancy. The study found a small increase in the chance of heart defects. However, many of the women in the study were also taking other medications. Because of this, it is hard to know whether the slightly higher rate of heart defects was due to mesalamine, a combination of medications, the underlying medical condition, or other factors. 

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

Mesalamine is not expected to 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).  

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

Studies have not been done to see if mesalamine can increase the chance of behavior or learning issues in children. 

Breastfeeding while taking mesalamine: 

Mesalamine passes into breast milk in small amounts. Most babies have not experienced any side effects. Some babies have developed diarrhea after exposure to mesalamine in breast milk. If you are taking mesalamine while breastfeeding, monitor your baby closely for any changes in bowel movements. If you suspect your baby has symptoms (such as diarrhea), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

There have been some reports of men who had lower sperm counts while taking mesalamine. Sperm counts returned to previous levels after stopping the medication. Low sperm counts can affect the ability to conceive a pregnancy. There are no studies looking at the possible risks to a pregnancy when a man takes mesalamine. 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 on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

MotherToBaby is currently conducting a study looking at inflammatory bowel disease and the medications used to treat this condition 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-study/. 

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

What is mirtazapine?

Mirtazapine is a medication that has been used to treat major depressive disorder and severe vomiting/nausea during pregnancy (hyperemesis gravidarum). A brand name for mirtazapine is Remeron®. MotherToBaby has fact sheets on  depression https://mothertobaby.org/fact-sheets/depression-pregnancy/ and nausea and vomiting https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/.  

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. Some people may have a return of their symptoms (relapse) if they stop this medication during pregnancy.  

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

In some people, mirtazapine might raise the levels of a hormone called prolactin. High levels of prolactin can stop ovulation (part of the menstrual cycle when an ovary releases an egg). This would make it harder to get pregnant. Your healthcare provider can test your levels of prolactin if there is concern.  

Does taking mirtazapine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if mirtazapine could increase the chance of miscarriage. Depression itself might increase the chance for miscarriage.  

Does taking mirtazapine 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 mirtazapine, might increase the chance of birth defects in a pregnancy. Studies and case reports have looked at nearly 5,000 pregnancies with mirtazapine exposure and have not found an increased chance of birth defects. 

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

Some studies suggest that taking mirtazapine throughout pregnancy might 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). Research has also shown that when depression is left untreated during pregnancy, there could be an increased chance for pregnancy complications such as preterm delivery, low birth weight, and pre-eclampsia (high blood pressure and problems with organs, such as the kidneys) that can lead to seizures (called eclampsia). This makes it hard to know if it is a medication, an underlying condition, or other factors that are increasing the chance of these problems.  

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

The use of mirtazapine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms might include sensitivity to light and sound (called excitability), fast heart rate, tremors, and problems regulating body temperature shortly after birth. In most cases, these symptoms are mild and go away on their own. Some babies may need to stay in a special care nursery until the symptoms go away. Not all babies exposed to mirtazapine will have these symptoms. It is important that your healthcare providers know you are taking mirtazapine so that if symptoms occur your baby can get the care that’s best for them. 

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

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

Breastfeeding while taking mirtazapine:

Mirtazapine passes into breast milk in small amounts. Most nursing babies have not had reported side effects from the medication in breast milk. If you suspect the baby has any symptoms (being overly sleepy) contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if mirtazapine could affect a man’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 doxylamine succinate-pyridoxine hydrochloride in pregnancy and while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare provider.

What is doxylamine succinate-pyridoxine hydrochloride?

The combination of doxylamine succinate and pyridoxine hydrochloride is a medication that has been used to treat nausea and vomiting in pregnancy (NVP), also called “morning sickness.” For more information on NVP, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/.

Doxylamine succinate is an antihistamine. Antihistamines lessen the symptoms of allergic reactions and colds and help to treat insomnia (trouble sleeping). Pyridoxine hydrochloride is a form of vitamin B6.  In the United States, the combination of doxylamine and pyridoxine can be found under the brand name Diclegis^®. In Canada, it can be found under the brand name Diclectin^®. Doxylamine succinate and/or pyridoxine hydrochloride are also available as over-the-counter medications.

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 take doxylamine succinate-pyridoxine hydrochloride. Can it make it harder for me to get pregnant?

It is not known if doxylamine succinate-pyridoxine hydrochloride can make it harder to get pregnant.

Does taking doxylamine succinate-pyridoxine hydrochloride increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Doxylamine succinate-pyridoxine hydrochloride has not been shown to increase the chance of miscarriage.

Does taking doxylamine succinate-pyridoxine hydrochloride 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 doxylamine succinate-pyridoxine hydrochloride, might increase the chance of birth defects in a pregnancy.

Studies of hundreds of thousands of women have shown that taking doxylamine succinate-pyridoxine hydrochloride during pregnancy does not increase the chance of birth defects. Doxylamine succinate-pyridoxine hydrochloride has been recommended as a first-line treatment for NVP by the American College of Obstetricians and Gynecologists (ACOG) and by several medical organizations in Canada.

Does taking doxylamine succinate-pyridoxine hydrochloride in pregnancy increase the chance of other pregnancy-related problems?

Studies have found that taking doxylamine succinate-pyridoxine hydrochloride does not 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).

Does taking doxylamine succinate-pyridoxine hydrochloride in pregnancy affect future behavior or learning for the child? 

Studies that have followed children from ages 2 to 7 years have not found a higher chance of behavior or learning problems after exposure to doxylamine succinate-pyridoxine hydrochloride during pregnancy.

Breastfeeding while taking doxylamine succinate-pyridoxine hydrochloride: 

There are no studies looking at the combination of doxylamine succinate-pyridoxine hydrochloride while breastfeeding.

Antihistamines such as doxylamine can make people drowsy. It could cause drowsiness or irritability in a breastfeeding infant. If you suspect the baby has any symptoms (such as drowsiness or poor feeding), contact the child’s healthcare provider.

The product label for Diclegis^® recommends people who are breastfeeding not use this medication. However, the benefit of breastfeeding and using this medication might outweigh possible risks. Your healthcare providers can talk with you about using doxylamine succinate-pyridoxine hydrochloride and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes doxylamine succinate-pyridoxine hydrochloride, could it affect fertility or increase the chance of birth defects?   

Studies have not been done to see if doxylamine-pyridoxine could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects in humans. 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.