Medication Condition Research Study Design Proposed Teratogenicity/Fetotoxicity Recommendations
 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