Right Drugs and Vaccines in Pregnancy in 2022

Pregnant women frequently require medication to treat ailments such as asthma, epilepsy, depression, and others. The woman’s or her baby’s health could be jeopardized if she does not receive care.

Over-the-counter drugs, herbal and dietary items, including weight loss products, are used by a substantial percentage of pregnant women. These items, unlike prescription pharmaceuticals, are often used without the supervision of a healthcare provider and are not regulated in the same way.

There have been some safety concerns about using it during pregnancy. Patients who use prescription medications frequently also take nonprescription or herbal products at the same time, which may have clinically significant consequences.

Drug Intake By the Man Can Increase Risk in The Unborn Baby

Alcohol use by fathers may increase the chance of heart abnormalities in babies. In one research, paternal smoking was linked to cardiac abnormalities in one study. Chemotherapy or radiation therapy for a father’s cancer may put the fetus at risk for chromosomal abnormalities. Studies have revealed lower-than-normal chromosomal counts and chromosome structural abnormalities in the sperm of males with cancer.

Prescription medication use by fathers, such as cholesterol and blood pressure medicines, has not been associated with an increased incidence of birth abnormalities. More studies must be done to examine the safety of pharmaceuticals that have just been placed on the market. Despite the absence of evidence for a direct relationship between paternal exposure and fetal risk, caution is advised.

Drug Use In Pregnancy

Often women take drugs before recognizing they are pregnant in the first few weeks of pregnancy. A prescription other than a vitamin or mineral supplement is administered to about 59 percent of pregnant women. A dietary herbal supplement is used by about 13% of pregnant women.

At some point throughout their pregnancy, more than 90% of pregnant women consume prescription or nonprescription (over-the-counter) medicines or use social drugs like cigarettes, alcohol, or illegal narcotics. One of the basic issues in medical therapy is that certain medications taken during pregnancy may be hazardous to the unborn child.

Although it is preferable to avoid drugs while pregnant, it is often impossible and sometimes harmful since some women have medical issues that require continuous and episodic therapy (e.g. asthma, epilepsy, hypertension). New medical issues might arise during pregnancy, and existing ones can worsen (for example, migraine headaches), necessitating pharmaceutical intervention.

The mother’s and her baby’s health might be jeopardized if these issues are not addressed. Vitamins, minerals, iron, and nutritional supplements are also necessary for a pregnant woman’s and her fetus’s health. According to reports, around 8% of pregnant women require medication owing to a variety of chronic conditions and pregnancy-related problems.

Some antimalarial drugs have been shown to have an effect on the developing infant. If a pregnant woman uses doxycycline after the first 12 or 13 weeks of pregnancy, the baby’s milk teeth may become discolored.

The unborn baby can be at risk.

The baby is known as an embryo from the time of implantation into the uterine wall until about the eighth week of life. During this stage, specialized cells begin to form the vital organs, nervous system, bones, muscles, and blood, and development is rapid. The developing infant is referred to as a fetus after the eighth week of pregnancy.
Metabolism changes dramatically as the fetus and placenta grow and exert greater demands on the mother.

The way a drug affects a fetus is determined by the fetus’s stage of development as well as the drug’s strength and dose. There is a scarcity of data on the effects of medications during pregnancy.  Women who are trying to conceive or who want to conceive should stop taking all non-essential drugs 3-6 months before getting pregnant. 

Certain medications used in the early stages of pregnancy (15–21 days after fertilization) during the phase of blastogenesis may have an all-or-nothing effect on the fetus, either killing it or having no effect of any kind. The fetus is extremely resistant to birth abnormalities during this early period. Between the 3rd and 8th weeks following conception, when the embryo is undergoing organogenesis, the fetus is most prone to birth abnormalities. During this time, all of the main organs begin to form. Drugs that reach the fetus during this time may result in a miscarriage, a visible birth defect, or a persistent but subtle birth problem that is discovered later in life.

The embryo is known as a fetus after the 9th week. Maturation and growth are the main goals of development at this stage. Drug intake during this time frame is not linked to serious congenital abnormalities, but it does have the potential to affect the growth and function of normally developed organs and tissues.

Important Drugs to Be Taken During Pregnancy

It’s important to take good care of yourself before, during, and after your pregnancy. It can aid your baby’s growth and development while also keeping both of you healthy. It is the most effective way to ensure that your child has a healthy start in life. Prenatal vitamins, which can be taken in the form of capsules, pills, syrups, or any other form, are an important part of taking care of yourself and your unborn child.
Prenatal vitamins are supplements designed to provide pregnant women with the vitamins and minerals they need to have a healthy pregnancy. Your doctor may advise you to take them before you start planning for a pregnancy and while you’re pregnant.

Vaccines: Which One Should You Have in Pregnancy?

Some vaccinations are acceptable and advised for pregnant women before, during, and after delivery to keep them and their newborns healthy. Antibodies developed by women in reaction to these immunizations not only protect them but also cross the placenta and protect their kids from deadly illnesses early in life. Vaccinating a woman when she is pregnant also protects her from contracting a dangerous disease and then passing it on to her baby.

Here are the Commonly Recommended Vaccines in Pregnancy

1. Tetanus Vaccine –

Tetanus is transmitted to humans through cuts or wounds.
TETANUS (T) produces muscular stiffness that is unpleasant. Tetanus can cause major health problems, such as the inability to open one’s lips, difficulty swallowing and breathing, and even death.

2. COVID-19 Vaccine –

If you are pregnant or have recently been pregnant, you are more likely to become seriously ill from COVID-19 than non-pregnant people. Furthermore, if you have COVID-19 while pregnant, you are at a higher risk of problems that might harm your pregnancy and growing baby.
Getting vaccinated against COVID-19 can help keep you from becoming really ill from the virus.
The COVID-19 vaccine is advised for women who are pregnant, nursing, attempting to conceive, or may become pregnant in the future.
Pregnant women should keep their COVID-19 immunizations up to date, including obtaining a COVID-19 booster dose when it’s due.
The body of evidence demonstrating that COVID-19 immunization during pregnancy is both safe and efficacious is growing.

3. Influenza Vaccine –

In some countries, the flu vaccine is one of the recommended vaccines given to pregnant women and others. According to a recent study, women who get the influenza vaccine during pregnancy are no more likely than those who don’t have kids to have unfavorable health outcomes in early infancy.

Other vaccinations you may need during pregnancy:

• Hepatitis A (HepA): If you have a particular risk factor for hepatitis A, such as chronic liver disease, or if you live with someone who has hepatitis A, you should get this vaccination. The vaccination is often given in two doses, six to eighteen months apart. If you need to start or continue your HepA vaccination series, you may do so safely while pregnant.

• If you have a specific risk factor for hepatitis B, such as being a healthcare worker, you’ll require this vaccination. The vaccine is administered in three doses, and all brands, except Heplisav-B, are safe to use in pregnant women. It’s okay to start or continue the HepB vaccination series during pregnancy if necessary. It’s also critical that your newborn infant gets his or her first dose of the HepB vaccine within 24 hours of delivery.
• Haemophilus influenzae type b (Hib): Adults with specific high-risk disorders, such as a non-functioning spleen, require Hib immunization. If you require the Hib vaccination, you can obtain it at any time while you’re pregnant.
• If you are a first-year college student living in a residence hall and have never been vaccinated or have been inoculated before the age of 16, you will require MenACWY. If you have one of the various health issues, such as a non-functioning spleen, you may require the MenACWY vaccination. If you require MenACWY in your pregnancy, you can get it safely.
• MenB is required if you have one of numerous health conditions*, such as a non-functioning spleen. After consulting with your healthcare practitioner, you may be vaccinated with the MenB vaccination if you are 23 years old or younger (even if you do not have a high-risk medical condition). Because no trials on the MenB vaccine in pregnant women have been completed, your healthcare professional will need to assess if the advantages of immunization exceed the dangers.
• Pneumococcal Pneumovax, PPSV, Prevnar, PCV: If you have a risk factor for pneumococcal illness, such as diabetes, you’ll require one or both of these immunizations (but not pregnancy-induced diabetes). If you’re unclear about your risk, see your doctor to see if you need any of these immunizations. It is safe to have any pneumococcal vaccination during pregnancy if you are a candidate.

The Following Vaccines Are Not Recommended During Pregnancy:

• Measles, Mumps, Rubella (MMR): Although the MMR vaccination is not recommended for use during pregnancy, if you do get it, you should not be concerned. Your healthcare practitioner will test your blood throughout your prenatal care to determine if you require MMR after delivery. It’s better to get vaccinated before attempting to conceive so that you (and any future children) are protected.
• Varicella (Chickenpox): Varicella vaccine is not advised to be offered during pregnancy. However, if you unknowingly receive it, this is not really a serious concern. If you’ve never had chickenpox, were never vaccinated, or were vaccinated but only had one dose, it’s better to get the vaccination before attempting to get pregnant or after you’ve finished your pregnancy to protect yourself (and any future child). The vaccination is administered in two doses, separated by 4–8 weeks.
• Zoster (shingles): If you’re 50 or older, the Shingrix brand of shingles vaccination is advised in a two-dose course. However, because the safety of the Shingrix vaccine during pregnancy is unclear, you should postpone getting Shingrix until after your pregnancy is over.

References;

https://www.medscape.com/viewarticle/813743

https://www.cdc.gov/pregnancy/meds/treatingfortwo/index.html