If your doctor prescribes a medication for you during your pregnancy, rest assured that the drug probably poses far fewer risks than the effects of an untreated illness or infection. In fact, antibiotics such as penicillin are frequently prescribed during pregnancy to treat a variety of bacterial infections. While most of these drugs are considered safe for mother and baby, there are some exceptions. The antibiotic erythromycin estolate can affect a pregnant woman's liver function, while a newer group of drugs called fluoquinolones may harm your baby's developing bones and cartilage. Tetracycline, another commonly used antibiotic, is not recommended after the fourth month of pregnancy because it may stain your baby's primary and permanent teeth.
Fortunately many moms-to-be can now safely cope with chronic health problems by using medication. High blood pressure can be treated with methyldopa or a number of other medications. But it's best to avoid a group of drugs called ACE inhibitors, commonly used to treat high blood pressure. These drugs can damage fetal kidneys after the first trimester. While most asthma medications are considered safe, (including inhaled steroids and bronchodilator sprays containing terbutaline sulfate or albuterol), less is known about sprays containing salmeterol, so consult your doctor before use.
Recent studies also show that the most commonly prescribed depression medications (such as serotonin reuptake inhibitors, including fluoxetine [Prozac]) are not associated with an increased risk of birth defects or pregnancy complications. Babies exposed to these drugs late in pregnancy may be more jittery than usual for the first few days after birth, but appear to develop normally thereafter.
While it's wise to avoid unnecessary medications during pregnancy, you don't have to suffer to protect your baby. As long as you follow your doctor's advice, you can get the relief you need without undue risks to anyone.
Dr. Schwarz, obstetrical consultant to the March of Dimes, is past president of the American College of Obstetricians and Gynecologists; vice chairman for clinical services, department of obstetrics and gynecology, Maimonides Medical Center; Emeritus Distinguished Service Professor of Obstetrics and Gynecology, SUNY Downstate Medical Center, both in Brooklyn.
Originally published in American Baby magazine, April 2004.
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