Pregnancy Risks

Pregnancy categories for commonly used drugs or special risks

How the categories work:

In regards to threats to the health and viability of a fetus, there are 6 categories that the FDA (Food and Drug Administration) use to categorize the safety of a drug is during pregnancy. The main 5 categories are categories A B C D and X ordered from safest (A) to least safe (X). The last other category is N which means there is no statement from the FDA on how safe it is. In general, category A means that human and animal trials have proven to do no harm to the fetus (generally in the first trimester). Category B means that animal studies show no risk to the fetus, but there is not enough data in regards to human trials to determine its safety. Category C is when animal trials show risk to the fetus but there is not enough data from human consumption to make a further statement. Categories D and X somewhat overlap eachother: Both mean that animal and human trials show risk to the fetus however category D drugs may in rare occasions be used despite the risk if there is sufficient benefit (usually in terms of life or death situations involving the pregnant mother),

https://www.drugs.com/pregnancy-categories.html

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For those who are pregnant or plan on becoming pregnant, abusing recreation drugs is extremely discouraged. Regardless however, some may decide to abuse drugs anyway and so here is some basic information on pregnancy risks and categories of commonly abused drugs

DISCLAIMER: We are NOT medical professionals of any sort. What you choose to do with this information is your decision and we hold no responsibility for it. This page is simply a compilation of peer reviewed and cited information in regards to pregnancy risks. We hope that if you are in fact pregnant that you partake in absolutely NO drug use whatsoever, however this page is for those of you who will regardless and serves to promote harm reduction. Remember, the safest thing you can do while pregnant is to avoid drugs completely.

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Alcohol

Drinking while pregnant creates and strengthens many risks associated with childbirth. Binge drinking during the first three months of pregnancy greatly increases the risk of an early miscarriage as alcohol passes easily through the placenta. After this period, regular alcohol consumption may contribute to stunted brain and body growth of the foetus. It will also increase the chances of premature labour, which can be incredibly dangerous for both the baby and mother.

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-alcohol-and-pregnancy.pdf

Stimulants'

Amphetamine sulfate (Adderall):

Pregnancy category C according to the FDA. Evidence has shown usage during pregnancy can cause premature birth, low birthweight, and withdrawal syndrome in the baby. This occurs more often in abuse of adderall. Recommendation is to consult with a physician if you are pregnant.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf

https://www.drugs.com/adderall.html

Caffeine

A relatively safe substance to take in moderation while pregnant, caffeine usage is not discouraged if consumption is under 200mg (two cups of instant coffee) a day. However, Repeated ingestion of high doses of caffeine during pregnancy carries significant risk to the unborn foetus. Reduction of birth weight is common and miscarriages can even be induced by heavy usage.

http://www.nhs.uk/chq/pages/limit-caffeine-during-pregnancy.aspx?categoryid=54&subcategoryid=130

Cocaine

Using cocaine while pregnant can cause many complications and be incredibly damaging to a foetus’ health. Normal pregnancy risks, such as high blood pressure and difficulty in childbirth, can be exasperated by cocaine consumption. As well as difficulties for the mother, babies born to cocaine taking mothers normally experience many birth defects, such as drastically reduced weight and head size. Ingesting cocaine while pregnant is especially dangerous as it greatly increases the risks of seizures for the mother.

https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-effects-maternal-cocaine-use

Crack cocaine (Freebase cocaine)

Smoking crack cocaine while pregnant can cause serious and permanent damage to an unborn child. As crack cocaine is chemically very similar to powdered cocaine, its usage carries many of the same risks that mothers who use powdered cocaine face. Birth defects are commonplace for the children of crack cocaine smoking mothers; Newborn babies are sometimes born underweight, or with smaller heads. Substantial harm to the mother can also be caused as the chances of seizures are greatly increased.

https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-effects-maternal-cocaine-use

Dextroamphetamine (Dexedrine):

Pregnancy category C according to the FDA. Animal trials indicate teratogenic effects meaning that it affects the genes of the fetus causing congenital defects. One reported human case supports this theory

https://www.drugs.com/pregnancy/dextroamphetamine.html

http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017078s042lbl.pdf

Evekeo:

Pregnancy category C according to the manufacturers site. dextroamphetamine (50% of the ingredients in evekeo) caused congenital defects in mice.

https://www.evekeo.com/assets/evekeo-pi.pdf

Focalin

MDMA

As a powerful and stressful stimulant, MDMA can be very dangerous for pregnant woman. Users expose themselves to extreme risks such as heart problems and dangerous blood pressure increases. Heavy usage can have a profound negative impact on both an infant’s mental and motor development in early life. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428761/

Methamphetamine

Using methamphetamine while pregnant can cause dangerous compilations for both the mother and foetus. After sustained consumption, abruption of the placenta can occur; this causes the separation of the mothers placental lining from their uterus and is potentially very damaging for the mother. Newborn babies may experience lethargy along with heart and brain abnormalities which will inevitably affect the child’s development and growth.

https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-risks-methamphetamine-abuse-during-pregnancy

Methylphenidate (Ritalin, Concerta):

Pregnancy category C according to the FDA. High doses administered to rabbits in animal studies resulted in fetuses having congenital malformations (spina bifida mainly which is an incomplete development of the spine).

http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/010187s069,018029s040,021284s011lbl.pdf

Nicotine

Although Nicotine is considered a ‘mild’ stimulant, it is incredibly dangerous to smoke while pregnant. Expectant mothers consuming nicotine are increasing several risks to their unborn children. These risks include miscarriage, stillbirth and even sudden foetus death. Smoking causes reduced natural breastmilk production. Nicotine can be passed on to babies through breastfeeding, causing colic and upsetting the baby constantly.

http://www.nhs.uk/smokefree/why-quit/smoking-in-pregnancy

Vyvanse

It is not advised to continue or start Vyvanse usage while pregnant. Not much is known about potential risks to the mother and unborn child. Therefore, caution should be exercised and this drug should be avoided by pregnant mothers. Vyvanse is excreted into breastmilk and so the drug can be passed on to breastfed children easily.

http://www.fda.gov/downloads/Drugs/DrugSafety/ucm089823.pdf

Opioids

Fentanyl

Heroin

Hydromorphone

Ketobemidone

Morphine

Norcos

Oxycodone

As with other synthetic opioids, usage of oxycodone during pregnancy carries some risk. High enough dosages can easily cross the placenta barrier and cause respiratory depression for the developing foetus. New born infants can also be birthed with a life threatening dependence for oxycodone, if the mother’s usage is sustained. The new-born child may also experience potentially fatal symptoms such as seizures and rigidity.

http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022272s027lbl.pdf https://www.drugs.com/oxycodone.html

Oxymorphone

Vicodin

It is strongly advised against to use high doses of Vicodin while pregnant. After sustained usage by the mother, babies born can experience life threatening withdrawal symptoms at birth. This medicine can also easily pass into breastmilk and this can harm the baby greatly, so breastfeeding while using Vicodin is discouraged. There is also a small teratogenic risk prevalent, meaning using Vicodin while pregnant could lead to stunted foetus growth.

https://www.drugs.com/vicodin.html http://www.webmd.com/drugs/2/drug-3459/vicodin-oral/details/list-precautions

U4700 (spell check)

Benzodiazepines

In general the FDA has found that benzodiazepines as a class increase the risk for congenital malformations for the fetus when taken by a pregnant mother and should only be taken when the benefits absolutely outweigh the risks

Alprazolam (Xanax):

Pregnancy category D according to the FDA. Potential to cause congenital defects with the fetus if used during pregnancy.

http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018276s044,021434s006lbl.pdf

Bromazepam

Brotizolam

Chlordazepoxide

Clobazam

Clonazepam

Clorazepate

Diazepam (Valium):

Pregnancy category D according to the FDA. Potential to cause congenital defects proven through animal studies.

http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/013263s083lbl.pdf

Diclazepam

Estazolam

Etizolam

Flubromazepam

Flubromazolam

Flunitrazepam

Flutoprazepam

Flurazepam

Halazepam

Ketazolam

Loprazolam

Lorazepam (Ativan):

Pregnancy category D according to the FDA. Studies in animals show potential for congenital defects. Newborns upon delivery from mothers who used Ativan late into their trimesters were seen to have respiratory depression or stopped breathing completely.

http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017794s034s035lbl.pdf

http://www.accessdata.fda.gov/drugsatfda_docs/label/2006/018140s028lbl.pdf

Lormetazepam

Medazepam

Midazolam (Versed):

Pregnancy category D according to the FDA. Studies show increased chance of congenital malformations

https://www.drugs.com/pregnancy/midazolam.html

http://www.fda.gov/ohrms/dockets/dailys/01/Mar01/032101/cp00001_exhibit_02.pdf

Nitrazepam

Nordazepam

Oxazepam

Phenazepam

Prazepam

Pyrazolam

Quazepam

Temazopam

Triazolam

SSRIs

Citalopram

Escitalopram

Fluoxetine

Paroxetine

Sertraline

SNRIs

SARIs

NDRIs

MAOIs

TCAs

TeCAs

NMDA antagonists

Other antidepressants

Deliriants

DPH

Datura

Scopolamine

Tobacco