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Doody's Review ServiceReviewer: Gilad A. Gross, MD (Washington University School of Medicine)
Description: This is an all inclusive reference guide to fetal and neonatal risks associated with drugs used during pregnancy and lactation. The book is arranged in alphabetical order according to the drug's American generic name. Each drug is initially presented with a fetal risk recommendation, a breast feeding recommendation, and a risk factor category (classic A through X categorization), all contained in a color-coded box. This is followed with a descriptive fetal risk summary, a breast feeding risk summary, and references. The last edition of this book was published in 2005.
Purpose: The purpose is to provide clinicians with the best estimate of embryo/fetal and nursing infant risk associated with exposure to various drugs. The book is certainly a needed reference for clinicians.
Audience: Physicians and other healthcare professionals involved in the care of pregnant and lactating patients are the intended audience. It is appropriate for students, residents, and physicians at all levels in various specialties, but is directed predominantly at those in the fields of obstetrics/gynecology and pediatrics. The authors are experts in the areas of pharmacology, obstetrics/gynecology, and neonatal and developmental medicine, and have a long track record of success with this reference.
Features: This guide examines the pregnancy and breastfeeding recommendations for over 1,200 drugs based on a multitude of references. Fetal risk and breastfeeding summaries include numerous types of data including but not limited to animal data, known human data, pharmacokinetics, and metabolic physiology. The introduction chapter clearly defines pregnancy and breastfeeding recommendations as well as risk factor categories. Concluding fetal risk and breastfeeding summaries follow the recommendations with the intent of providing clinicians with sufficient data to counsel patients on the risk-benefit ratio of a particular drug to arrive at a decision about whether or not to expose the fetus or neonate to the drug. The alphabetical organization of the book is user friendly. The color-coded highlighted boxes with the fetal risk and breast feeding recommendations as well as the risk factor category allow one to quickly reference the conclusion of the longer explanations given in the summary sections. The size of the book means that is not that portable, but it comes with a code allowing access to an online version — a highly desirable feature.
Assessment: This is a useful, high quality manual of recommendations for the use of drugs in pregnancy and lactation. It certainly is the first book we turn to when posed with questions about the use of certain drugs in pregnancy and lactation. This edition covers 125 additional drugs and provides updates from the seventh edition. This is a highly valuable reference.
Jennifer Meyer, MD (Washington University School of Medicine) contributed to this review.