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But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.

Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth _ from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.

Women have to weigh those findings with the clear risks of stopping treatment, she said.

“The time to be thinking about all this is when you’re not pregnant,” when your doctor can consider how to balance mom’s and baby’s health and might switch brands, Chambers said.

That’s what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.

So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.

“They said my heart could take it,” Tussey said. Now four months pregnant, “it seems everything’s fine.”

Sometimes it’s a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn’t for the third trimester but isn’t a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.

And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, “the question is, `Do you really need it?’” she asked, advising a nasal spray instead.

Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS _ http://www.otispregnancy.org _ for consumer-friendly drug fact sheets or hotlines to speak with a specialist.

Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What’s the risk of skipping treatment? Is the risk only during a certain trimester?

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Online:

http://www.otispregnancy.org

http://www.cdc.gov/pregnancy/meds/index.html