Using Medicines during pregnancy

Medicines should be used during pregnancy only when they’re needed. Many medicines can be taken while you are pregnant, but it’s important to check with your health professional first. Sometimes it’s possible to relieve symptoms without medicines.

At other times, it may be essential to continue using a medicine, such as when the medicine helps to manage a long-term condition like asthma, diabetes, depression, or seizures. Without the medicine, your health or your baby’s health could be put at risk.

There are some medicines that should be used with caution or avoided during pregnancy. You should always talk to your doctor, pharmacist or other health professional about using medicines when you are pregnant.

Medicines that cause harm during pregnancy in various ways:

• Some medicines are transported across the placenta and can interfere with the baby’s development.
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• Others can damage the placenta and affect the amount of nourishment and oxygen delivered to the baby.
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• Some can contract the uterus and increase the risk of miscarriage or bring on premature labour.
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• Others may have side effects like drowsiness that may affect the baby around the time of birth.

It’s important to ask questions as you plan your pregnancy, and to make sure you get the right information about medicines at all stages of your pregnancy. 

The use of any medicine during pregnancy requires careful consideration of both risks and benefits by your health care professional. 

Any decision about taking a medicine during pregnancy should always involve your health professional and you.

There are some medicines that should be used with caution or avoided during pregnancy. 

Remember that medicines don’t just come as prescription — they include over-the-counter and complementary medicines.

Complementary medicines (also known as ‘traditional’ or ‘alternative’ medicines) include vitamin, herbal, aromatherapy and homeopathic products. Many complementary medicines have not undergone the same level of research as prescription and over-the-counter medicines, so often less is known about their effectiveness, possible side effects and interactions both overall and during pregnancy.

Medications formulated for pregnancy

Some vitamin preparations are formulated specifically for use during pregnancy. This ensures correct recommended intake of certain vitamins and minerals (such as folic acid) and avoids excess intake of other vitamins. It is advisable to discuss with your healthcare professional about your specific nutritional needs during pregnancy.

If you have a chronic medical condition and need medicine to treat it, it is important to have your condition assessed while you are planning for, or during your pregnancy. Your doctor is the best person to assess your medical treatment. Sometimes changes are needed to ensure the health of both you and your growing baby. 

Sources of information such as Product information and Consumer Medicines information leaflets often don’t provide detailed information about use in pregnancy, so your health professionals are the best source of information to guide you about the use of medicines during pregnancy.

One Cigarette a Day Greatly Raises your Cardiovascular disease Risk

Smoking Even One Cigarette a Day Raises Cardiovascular Risk

For people who think that smoking only one or two cigarettes a day carries little cardiovascular risk, a powerful new study maintains the only way to reduce risk is to quit, full stop.

The investigators anticipated that smoking one cigarette a day would be associated with about 5% of the excess relative risk of smoking 20 cigarettes a day, but they found it actually accounts for 46% of excess Coronary Heart Disease risk in men and 31% of the risk in women. 

For the less commonly reported smoking-related outcome of stroke, the excess risk associated with just one cigarette per day was 41% for men and 34% for women.

There's been a big shift from people smoking 20 to 25 cigarettes a day to only smoking a few cigarettes a day with the assumption that's good enough for them. Their view is that smoking only a couple a day can't be harmful and that's probably not far off the truth for risk for cancer. For many smokers that's probably the first thing that comes to mind, but cardiovascular risk is the big one.

The main public health impact of this is that smokers have done well in reducing and there are various methods to help them quit and cut down, but the aim is to keep on searching for those methods, find one that suits them, and to cut down and then quit completely."

The unfortunate thing for cardiovascular disease is that the adverse effects seem to come through quite quickly after only 2 or 3 years of smoking and the impact is quite big. The good thing is that if you quit smoking, a lot of your risk goes away quite quickly as opposed to cancer, where it takes several years to mainly go away.

Recurrent Miscarriage: May be linked to the poor quality of sperm

Sperm Damage may provide clues to Recurrent Miscarriage.
Oxidative stress and DNA damage in sperm may contribute to repeated miscarriages in female partners.

There is strong understanding of female factors that can contribute to recurrent pregnancy loss, but male factors that may play a role is far less known. Recurrent pregnancy loss — at least three consecutive miscarriages (before 20 weeks' gestation) — occurs in about 1-2% of couples, and about half of cases are unexplained. A lot of women undergo many tests to determine the cause, but many cases have no identified cause. 

It is important to know the medical history of male partners, examine them, and maybe offer a further investigation so that it can be established where the problem is, and perhaps offer the couple better treatment.

The role of the sperm

The sperm plays an important role in the formation of the placenta, which is critical for survival of an unborn baby. Some known risk factors for male infertility include genitourinary infection, varicocele, scrotal heat, and obesity. Some of these conditions might contribute to reactive oxygen species in semen, which could then cause sperm DNA fragmentation and subsequent pregnancy loss.

Frances Hayes, MBBCh, clinical director of the reproductive endocrine unit at Massachusetts General Hospital, Boston therefore has a take-home message; "Don't neglect the male. Sometimes there may be need to screen both potential parents for balanced translocation in the chromosomes, but most of the focus is typically on the woman."

 

The early-stage study, from scientists at Imperial College London, investigated the sperm quality of 50 men whose partners had suffered three or more consecutive miscarriages.

The research, revealed that, compared to men whose partners had not experienced miscarriages, the sperm of those involved in the study had higher levels of DNA damage.

Until recently recurrent miscarriage was thought to be caused by health issues with the mother, such as infection or immune problems.

"However, this research adds to a growing body of evidence that suggests sperm health dictates the health of a pregnancy. For instance, previous research suggests sperm has an important role in the formation of the placenta, which is crucial for oxygen and nutrient supply to the fetus."

The research team is now investigating what may trigger high levels of these reactive oxygen species. It is possible there may be bacteria from previous infections lingering in the prostate gland, which makes semen. This may lead to permanently high levels of reactive oxygen species.

Obesity can lower sperm health as well -- possibly because high levels of body fat can trigger an increase in reactive oxygen species.

Dr Channa Jayasena, lead author of the research from Imperial's Department of Medicine concludes: "It has taken medicine a long time to realise sperm health has a role to play in miscarriage -- and that the cause doesn't lie solely with women. Now we realise both partners contribute to recurrent miscarriage, we can hopefully get a clearer picture of the problem and start to look for ways of ensuring more pregnancies result in a healthy baby."