This sheet is about exposure to risperidone 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 risperidone? 

Risperidone is a medication that has been used to treat mental health conditions such as schizophrenia, bipolar disorder, and depression. It can be taken by mouth or given as an injection. Risperidone belongs to a group of medications called atypical or second-generation antipsychotics. Brand names for risperidone include Risperdal®, Risperdal Consta®, and Perseris®. 

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. 

MotherToBaby has a fact sheet on depression here: https://mothertobaby.org/fact-sheets/depression-pregnancy/.  

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

In some women, risperidone may raise the levels of the hormone 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 monitor your levels of prolactin if there is concern. 

Does taking risperidone increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies have linked risperidone to a higher chance of miscarriage. However, the evidence is conflicting and does not clearly prove that risperidone is the cause of this outcome. Other factors, such as the underlying condition being treated, may also increase the chance of miscarriage. 

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

Studies and case reports show mixed outcomes in babies exposed to risperidone before birth. Overall, reviews reported that the rate of birth defects was not higher than the background risk. If there is an increased chance of birth defects with risperidone use, it is likely to be small. 

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

Some studies have reported a higher chance of pregnancy-related problems, and other studies have not. One study found no increase in preterm delivery (birth before week 37). Another suggested that risperidone may increase the chance of low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

Risperidone may cause weight gain and problems with blood sugar, which can increase the chance of gestational diabetes. Gestational diabetes can increase the chance of other complications such as preterm delivery or the fetus being larger than expected (called macrosomia). Talk with your healthcare provider about your risk for gestational diabetes. If needed, they can monitor your blood sugar levels before and during pregnancy. More information about gestational diabetes can be found in our fact sheet at https://mothertobaby.org/fact-sheets/diabetes-pregnancy/.    

I need to take risperidone during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

The use of some medications during pregnancy may cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Babies exposed to risperidone near the time of delivery should be watched for stiff or floppy muscles, drowsiness, agitation, tremors, trouble breathing, and problems with feeding. In most cases, symptoms would be expected to go away in a few days without any long-term health effects. Not all babies exposed to risperidone will have these symptoms. It is important that your healthcare providers know you are taking risperidone so that if symptoms occur, your baby can get the care that is best for them. 

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

Studies to see if risperidone can increase the chance of behavior or learning issues for a child are limited. One study that looked at the filling of at least one prescription for risperidone after 18 weeks of pregnancy did not find an increased risk of developmental or behavioral disorders (autism, ADHD, learning or speech problems) in children followed up to age 14. Studies based on filled prescriptions cannot tell if the medication was taken as directed. This makes it hard to know if the study outcomes are related to medication or other factors. 

Breastfeeding while taking risperidone: 

Information on the use of risperidone during breastfeeding is limited. When taken in doses of up to 6 mg a day, risperidone was found in breast milk in small amounts. Side effects were not reported in a small number of breastfed infants. If you suspect the baby has any symptoms (being more sleepy than usual, jitteriness, poor feeding, crankiness, or unusual movements) contact the child’s healthcare provider.  

An older product label for risperidone recommends women using this medication should not breastfeed. Newer labels suggest weighing the benefit of using risperidone against possible risks. Your healthcare providers can talk with you about using risperidone and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Using risperidone may raise a man’s levels of the hormone prolactin, which might affect fertility (ability to make healthy sperm). Studies have not been done to see if risperidone could increase the chance of birth defects. In general, exposures that men 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 insulin aspart 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 providers. 

What is insulin aspart? 

Insulin aspart is a medication that has been used to control blood sugar in type 1, type 2, and gestational 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 NovoLog®, Fiasp®, and ReliOn®.  

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 during pregnancy might need to adjust the amount of medication they take as the pregnancy goes on. Having 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 gestational diabetes here: https://mothertobaby.org/fact-sheets/diabetes-pregnancy/.  

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

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

Does taking insulin aspart increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Taking insulin aspart before or during pregnancy is not expected to increase the chance of miscarriage. 

Does taking insulin aspart 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 aspart, might increase the chance of birth defects in a pregnancy. Insulin aspart is not expected to increase the chance of birth defects. 

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

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) have been reported with the use of insulin aspart.  

Poorly controlled sugar levels can increase the chance of health and pregnancy complications. It is important that your condition is well-treated before, during, and after pregnancy. 

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

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

Breastfeeding while taking insulin aspart: 

Insulin aspart is expected to get into breastmilk. Insulin aspart has not been well studied for use with breastfeeding, but using it while breastfeeding is not expected to increase risks for the breastfed infant. Insulin is a normal part of breastmilk and exposure to normal levels of the hormone may help lower the chance of type 1 diabetes in breastfed infants. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if insulin aspart could affect male 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 paternal exposures. 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 a paternal exposure? 

A paternal exposure is anything a male parent or sperm donor is exposed to before a pregnancy is conceived, while trying to conceive pregnancy, or after their partner is pregnant. This includes things such as prescription or over-the-counter medications, substance use (alcohol, tobacco, marijuana, opioid misuse), viruses, chemotherapy or radiation treatments (for conditions like cancer), and workplace exposures. This sheet discusses paternal exposures in general. Please contact MotherToBaby to discuss specific exposures. 

Can paternal exposures affect fertility or make it harder to conceive a pregnancy? 

Some exposures may affect a male’s fertility (ability to conceive a pregnancy) by lowering the desire for sex, reducing the ability to perform sexually, or by directly changing the sperm. Changes to sperm can affect the size or shape, the number of sperm produced, or how the sperm move. Some changes could cause a male to be unable to conceive a pregnancy (infertility) or to take longer to conceive a pregnancy. 

Do paternal exposures increase the chance of birth defects in a pregnancy? 

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.  

A male parent does not share a blood connection with a pregnancy, so medications or chemicals in their bloodstream do not reach the fetus during a pregnancy. Substances that a male is exposed to might enter the semen in small amounts. However, for most exposures, sexual intercourse during pregnancy is not expected to increase the chance of birth defects. This is because the amount of the substance in the semen is usually too small to cause problems for the pregnancy. For information about specific substances, contact a MotherToBaby specialist. 

If a male uses alcohol, tobacco, or other substances, can that affect their fertility or a partner’s pregnancy? 

Alcohol, tobacco, and other substances can affect the number or movement of the sperm. Studies have not found paternal exposures to these substances to cause an increased chance of birth defects.  

If your partner is pregnant, it is recommended to stop smoking or not smoke around the person who is pregnant (including in their house or car) because exposure to secondhand smoke can cause pregnancy complications. For more information, see the MotherToBaby fact sheet about cigarette smoke at https://mothertobaby.org/fact-sheets/cigarette-smoking-pregnancy/.  

If a male has a virus, can it affect a partner’s pregnancy? 

Research has shown some viruses can be found in semen. Depending on the virus, this could be temporary, or last for years. There are viruses in the semen that can be passed to a sexual partner during intercourse, and then to the fetus if the partner is pregnant. Some viruses can be harmful to the fetus. 

One such example is the Zika virus. If a male is infected with Zika virus, the virus can pass to a sexual partner during intercourse. If the partner is pregnant or gets pregnant soon after, there is a chance the virus will pass to the fetus. If this happens, it can increase the chance for a pattern of birth defects called congenital Zika syndrome. For more information, see the MotherToBaby fact sheet about Zika virus at  https://mothertobaby.org/fact-sheets/zika-virus-pregnancy/.  

Zika is not the only infection that a male can give to a partner that could cause negative pregnancy outcomes. Contact MotherToBaby to talk about specific exposures. 

If a male has chemotherapy or radiation treatments, can that affect their fertility or a partner’s pregnancy? 

Cancer treatment can affect sperm production. Sperm production may return to normal after chemotherapy or radiation treatment, or it might not. Males who need cancer treatment can talk to their healthcare providers about their options to save or protect sperm to have children in the future (fertility preservation).    

Because different types of cancer require different forms of treatment, there are no general recommendations on cancer treatment and pregnancy. Before trying to get pregnant, talk to your healthcare provider about the best time to start trying. At this time, there are no studies showing an increase in birth defects in children of males who were treated for cancer. 

Can a male’s exposures in the workplace affect their fertility or a partner’s pregnancy? 

Several studies have looked at the reproductive health of males who are exposed to various substances in the workplace, including lead, certain types of chemicals called organic solvents, pesticides, and radiation. Some studies suggest that these exposures may be associated with changes to the sperm, less sperm production, decreased fertility, and a higher chance for miscarriage or giving birth early (pre-term birth) in the partners of these workers. Other studies have found no increased chance for miscarriage or giving birth early (pre-term birth) when males have workplace exposures. Most workplace exposures in males have not been clearly associated with a higher chance of birth defects.  

Males exposed to heavy metals and other chemicals in the workplace may carry these agents into their cars and homes on their clothes and shoes. This may cause their partners to be directly exposed to these metals or chemicals. As a precaution, anyone who is exposed to heavy metals or chemicals in the workplace may want to change their clothes and shoes before coming home. There are general tips on working with chemicals in the MotherToBaby fact sheet Reproductive Hazards of the Workplace: Tips for Job Safety https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/. 

Please click here for references.

This sheet is about exposure to hydroxyurea 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 hydroxyurea?

Hydroxyurea is a medication that has been used to treat certain blood disorders (sickle cell disease, specific types of blood cancers) and a skin cancer called squamous cell carcinoma. Some brand names for hydroxyurea are Hydrea® and Siklos®.

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 hydroxyurea. Can it make it harder for me to get pregnant?

It is not known if hydroxyurea can make it harder to get pregnant. However, having sickle cell disease may make it harder to get pregnant.

Does taking hydroxyurea increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. In 1 study of women with sickle cell disease who were taking hydroxyurea 1 month before a pregnancy started, when a pregnancy began (conception), and during the pregnancy, a higher chance for miscarriage was noted. However, research also shows that some of the conditions this medication is used to treat could increase the chance of miscarriage. This makes it hard to know if it is the medication, the condition, or other factors that could increase the chance for miscarriage.

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

Information on the use of hydroxyurea in human pregnancy is very limited. No birth defects were reported in over 100 case reports of women’s use of hydroxyurea in pregnancy.

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

Preterm delivery, low birth weight, and respiratory distress (trouble breathing) in the baby have been reported after exposure to hydroxyurea during pregnancy. However, some of the conditions this medication is used to treat can increase risks to a pregnancy. That makes it hard to know if the medication, the condition being treated, or other factors that are related to reported issues.

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

Studies have not been done to see if hydroxyurea increases the chance for behavior or learning issues.

Breastfeeding while taking hydroxyurea:

Hydroxyurea gets into breast milk. There is no information on possible side effects in nursing children who are exposed to hydroxyurea through breastmilk.

An expert panel from the National Institutes of Health and the product labels for hydroxyurea recommend that women who are breastfeeding not use this medication. But the benefits of treating your condition, along with the benefits of breastfeeding your baby, may outweigh possible risks. Talk with your healthcare providers about the best way to treat your condition while breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

There have been reports of lowered sperm count (number of sperm) and lowered sperm motility (movement of sperm) in men who take hydroxyurea. This can affect a man’s fertility (ability to get a woman pregnant). It is not known if hydroxyurea can increase the chance of birth defects above the background risk when taken by men. 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 metformin in pregnancy and while breastfeeding. This information is based on available published literature. This information should not take the place of medical care and advice from your healthcare provider.

What is metformin?

Metformin is a medication that has been used to treat type 2 diabetes, insulin-resistance in polycystic ovary syndrome (PCOS), obesity (high body mass index (BMI)), and gestational diabetes. It is sold under brand names including Glucophage®, Glumetza® and Fortamet®.

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.

High blood sugar levels before and during pregnancy increase the chance of birth defects and other complications. For more information about diabetes during pregnancy, please see the MotherToBaby fact sheets on Type 1 and Type 2 Diabetes at https://mothertobaby.org/fact-sheets/type-1-and-type-2-diabetes/ and Gestational Diabetes at https://mothertobaby.org/fact-sheets/diabetes-pregnancy/.

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

Based on the studies reviewed, is it not known if metformin can make it harder to get pregnant. Metformin has been used to treat PCOS, a condition that can make it harder to get pregnant.

Does taking metformin increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Metformin is not expected to increase the chance for miscarriage. Poorly controlled diabetes in the first trimester of pregnancy can increase the chance of miscarriage.

Does taking metformin 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. Use of metformin during pregnancy is not expected to increase the chance of having a baby with a birth defect. Poorly controlled diabetes in the first trimester of pregnancy can increase the chance of having a baby with a birth defect.

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

Some studies have suggested women with gestational or type II diabetes who were treated with metformin had smaller babies at the time of delivery than those who were treated with insulin. The children exposed to metformin during pregnancy quickly gained weight after birth. Some studies have shown that children exposed to metformin during pregnancy may have a higher chance of having obesity in childhood. However, other studies did not show a difference in obesity in children of women who took metformin in pregnancy compared to women who did not take metformin or those who took insulin.

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

Taking metformin during pregnancy is not expected to affect future behavior or learning for the child.

Breastfeeding while taking metformin:

Metformin gets into breastmilk in small amounts. One study found no problems in breastfed infants. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

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

It is not known if metformin could affect fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. Some studies have suggested that use of metformin may reduce testosterone levels while other studies have suggested that better control of insulin may help improve sperm production. One study suggested that men given a prescription for metformin in the 3 months before conception might be associated with genital defects in the infant. However, no higher chance for birth defects was reported in a different study that looked at ~1,700 children of men who were prescribed metformin to treat type 2 diabetes in the 3 months before conception. Prescription based studies cannot tell us if the person actually took the medication or if they took it correctly. In general, exposures that men 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.

*Section updated June 2024