Amitriptyline |
Major depressive disorder; Migraine prophylaxis |
Observational and
animal studies [54-57] |
Interferes with embryo development in
animals; no confirmed teratogenicity in humans |
Can be used in
pregnancy |
Lithium |
Bipolar disorder |
Observational and animal studies [58,
59] |
Ebstein anomaly characterized by abnormal development of the
tricuspid valve |
Do not offer lithium for women who are planning to get
pregnant |
Paroxetine; Fluoxetine |
Major Depressive Disorder |
Observational and
animal studies [60-62] |
Cardiac defects, anencephaly and atrial
septal defects. No adverse effects in animal studies |
Avoid paroxetine
and fluoxetine or if no alternative agent, get fetal echocardiogram
22-24 weeks |
Prednisone |
Inflammatory conditions including rheumatoid arthritis,
lupus nephritis, inflammatory bowel disease, asthma |
Observational and
animal studies [35, 63, 64] |
Oral clefts, low birth weight, preterm
birth, preeclampsia, and gestational diabetes mellitus |
Use with
caution as limited evidence supports association with observed
fetotoxicity and pregnancy morbidity |
Statins |
Dyslipidemia |
Observational and animal studies [35] |
No
clear teratogenicity identified in recent studies |
Contraindicated,
with recent shift to labeling it as being safe by the FDA |
Warfarin |
Thromboprophylaxis in patients with mechanical heart valve |
Observational and animal studies [61, 65, 66] |
Skeletal defects
including nasal hypoplasia and stippled epiphyses |
Contraindicated
especially in first trimester; Switch to alternative closer to
delivery |