Reviewer: Jay P. Goldsmith, MD (Tulane University School of Medicine)
Description: This is the ninth edition of a guide to the risks posed by the use of over 1,100 drugs during pregnancy and breastfeeding. This guide differs from FDA recommendations, which the authors have purposely omitted for the first time because (according to them) the FDA categories (A, B, C, D, X) are overly simplistic and lead to inappropriate consequences. The previous edition was published in 2008.
Purpose: The book is intended to guide perinatal healthcare providers in advising mothers about the risks of drugs they may take in gestation and while lactating. These objectives are daunting since many factors affect the risks of drug ingestion including dose, timing of gestation, genetics, and environmental factors, which all may play a role in the potential toxicity. The authors have succeeded in creating probably the most helpful and practical guide in this field.
Audience: The audience includes all perinatal healthcare providers and anyone who may prescribe drugs to mothers during pregnancy and lactation. The authors are well-known authorities in the fields of pharmacology and maternal-fetal medicine.
Features: Each drug is presented in a similar format: a brief pregnancy summary, fetal risk and breastfeeding summaries, and references. This edition includes 105 additional drugs. The book is truly a pharmacological reference. For the uninitiated, an introductory chapter on the physiology and biochemistry of drugs reaching the fetus or baby by crossing the placenta or during lactation would be helpful.
Assessment: This is an essential reference for all perinatal care providers as well anyone who prescribes drugs to pregnant or lactating mothers. Updating it every three years keeps it current and increases its value. The monographs summarize the known and possible effects of drugs on the fetus and/or baby, giving useable advice that is easy to read. This guide is more comprehensive and practical than other guides, such as the appendix of Breastfeeding: A Guide for the Medical Profession, 7th edition, Lawrence and Lawrence (Elsevier, 2011).