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1.  Medications in the First Trimester of Pregnancy: Most Common Exposures and Critical Gaps in Understanding Fetal Risk 
Pharmacoepidemiology and drug safety  2013;22(9):1013-1018.
Purpose
To determine which medications are most commonly used by women in the first trimester of pregnancy and identify the critical gaps in information about fetal risk for those medications.
Methods
Self-reported first-trimester medication use was assessed among women delivering liveborn infants without birth defects and serving as control-mothers in two large case-control studies of major birth defects. The Teratology Information System (TERIS) expert Advisory Board ratings of quality and quantity of data available to assess fetal risk were reviewed to identify information gaps.
Results
Responses from 5,381 mothers identified 54 different medication components used in the first trimester by at least 0.5% of pregnant women, including 31 prescription and 23 over-the-counter medications. The most commonly used prescription medication components reported were progestins from oral contraceptives, amoxicillin, progesterone, albuterol, promethazine, and estrogenic compounds. The most commonly used over-the-counter medication components reported were acetaminophen, ibuprofen, docusate, pseudoephedrine, aspirin, and naproxen. Among the 54 most commonly used medications, only two had ‘Good to Excellent’ data available to assess teratogenic risk in humans, based on the TERIS review.
Conclusions
For most medications commonly used in pregnancy, there are insufficient data available to characterize the fetal risk fully, limiting the opportunity for informed clinical decisions about the best management of acute and chronic disorders during pregnancy. Future research efforts should be directed at these critical knowledge gaps.
doi:10.1002/pds.3495
PMCID: PMC3996804  PMID: 23893932
medication; pregnancy; fetal risk; teratogen
2.  FRIL: A Tool for Comparative Record Linkage 
A fine-grained record integration and linkage tool (FRIL) is presented. The tool extends traditional record linkage tools with a richer set of parameters. Users may systematically and iteratively explore the optimal combination of parameter values to enhance linking performance and accuracy. Results of linking a birth defects monitoring program and birth certificate data using FRIL show 99% precision and 95% recall rates when compared to results obtained through handcrafted algorithms, and the process took significantly less time to complete. Experience and experimental result suggest that FRIL has the potential to increase the accuracy of data linkage across all studies involving record linkage. In particular, FRIL will enable researchers to assess objectively the quality of linked data.
PMCID: PMC2656092  PMID: 18998844
3.  Prophylaxis and Treatment of Pregnant Women for Emerging Infections and Bioterrorism Emergencies 
Emerging Infectious Diseases  2006;12(11):1631-1637.
Infectious disease emergency preparedness planners should consider the special medical issues of pregnant women.
Emerging infectious disease outbreaks and bioterrorism attacks warrant urgent public health and medical responses. Response plans for these events may include use of medications and vaccines for which the effects on pregnant women and fetuses are unknown. Healthcare providers must be able to discuss the benefits and risks of these interventions with their pregnant patients. Recent experiences with outbreaks of severe acute respiratory syndrome, monkeypox, and anthrax, as well as response planning for bioterrorism and pandemic influenza, illustrate the challenges of making recommendations about treatment and prophylaxis for pregnant women. Understanding the physiology of pregnancy, the factors that influence the teratogenic potential of medications and vaccines, and the infection control measures that may stop an outbreak will aid planners in making recommendations for care of pregnant women during large-scale infectious disease emergencies.
doi:10.3201/eid1211.060618
PMCID: PMC3372351  PMID: 17283610
Pregnancy; bioterrorism; communicable diseases; vaccines; synopsis
4.  Ensuring the Safe and Effective Use of Medications During Pregnancy: Planning and Prevention Through Preconception Care 
Maternal and Child Health Journal  2006;10(Suppl 1):129-135.
doi:10.1007/s10995-006-0102-2
PMCID: PMC1592140  PMID: 16850277
Preconception care; Medications; Pregnancy; Anticonvulsants; Asthma; Isotretinoin

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