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Chelsea at Crunch Gym

Forty Weeks of Fitness!

Chelsea, our pregnancy fitness expert, is a certified personal trainer at Crunch gym in San Francisco, California. She gave birth to her daughter, Madeira Re, in July 2006. Read more

Exercise, Good Food, And Prenatal Care Are the Keys

By Rebecca D. Williams

Some medications have a long history of being used in pregnancy without problems. A pregnant woman shouldn't be deprived of drug therapy she really needs, says Sandra Kweder, M.D., the co-chair of FDA's task force on pregnancy labeling. She adds that women with pre-existing medical conditions such as epilepsy, lupus, asthma, or high blood pressure shouldn't quit their drugs because of pregnancy. Safer drugs can be used if necessary, but those medical conditions still need to be treated.

Kweder explains, "A common thing with patients is that they'll say, 'I know I'm supposed to take medication, but I'm worried about my baby, so I'll take less of it instead.' They'll take it every other day, or half as much. That's not wise."

The risks of a drug have to be weighed against its benefits. For example, some epilepsy drugs are known to cause birth defects, but an epileptic seizure can cause brain damage to the fetus. Most experts agree that the benefits of medication in such cases outweigh the risks.

Other drugs, however, are not so clear-cut. "It's really hard because there aren't easy answers," says Kweder. "For a baby to be healthy, it needs a mother who's healthy." However, most drugs have not been tested scientifically in pregnant women. Reliable scientific information about medication use in pregnancy is often incomplete or nonexistent. FDA is trying to change that.

The agency has begun a comprehensive review about how it regulates drugs for pregnant women and how safety information is communicated on the label. The present system is not as helpful as the agency would like. "The system has been criticized, and rightly so," says Kweder. "It is complicated to interpret data for medications used in pregnancy. We're making progress, but it's slow."

A new system is needed, she says, but it will be difficult to create. Drugs can't be tested in pregnant women the same as in other groups of people. Animal studies, while helpful, don't necessarily show what a drug will do to a woman and developing fetus.

In the meantime, a woman who has taken a drug and discovers she is pregnant should consult her doctor and avoid making decisions about her pregnancy in panic. While about 80 percent of approved drugs lack adequate scientific evidence about use in pregnancy, that doesn't necessarily mean they can harm the fetus or are harmful in the doses prescribed.

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