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birth defects
with use of chloroquine during pregnancy is not significantly
higher than the background rate of birth defects of 3-5%.
Chloroquine is often the medication of choice for malaria
treatment during pregnancy. Chloroquine should not be used
if the woman has a history of liver disease
or glucose-6-phosphate dehydrogenase deficiency.
Small amounts of chloroquine are transferred into breast milk.
However, because the exposure
to nursing infants is low, harmful effects are considered
unlikely (Committee on Drugs, American Academy of Pediatrics,
1994).
Mefloquine
Mefloquine
use during pregnancy has not been shown to be associated with
an increased risk for pregnancy loss, or other adverse effects
during the second and third trimesters (Steketee et al, 1996).
One study evaluated over 500 pregnancies that included first
trimester exposure to Mefloquine and did not find a significantly
increased risk for birth defects (Phillips-Howard et al, 1998).
This study did show an apparent increased risk for pregnancy
loss. The authors concluded that the rate of pregnancy
loss was not increased when compared to the high background
rate of the population studied (Phillips-Howard et al, 1998).
Additional studies evaluating 167 women and 218
women, respectively, did not find an increased risk for a
congenital malformation
or miscarriage (Harinasuta, 1990; Elefant, 1991).
Small amounts of Mefloquine are excreted into breast milk.
However, adverse effects from exposure to nursing infants
are not expected because the amount ingested would be very
small (Edstein et al, 1988).
Doxycycline
While doxyclcline
has been used for the treatment of malaria, pregnant women
should avoid taking doxycycline for malaria prevention during
pregnancy. Doxycycline is a tetracycline derivative
that is assumed to cause similar effects of tetracycline exposure
during pregnancy including staining of the teeth in the fetus
and depressed fetal bone growth (Rendle-Short, 1962).
Malarone
Malarone
is a combination of atovaquone and proguanil HCl used in the
prophylactic treatment of malaria.
There are no adequate or well-controlled studies of Malarone
use or its individuals components in pregnancy. Proguanil
has been used for in Europe with no reported
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