Expectorants While Pregnant

An estimated 10 percent or more of birth defects are the result of maternal drug exposure, according to the American Academy of Family Physicians, or AAFP. If you’re pregnant, it’s important to ask your doctor before using any medication. If you’re suffering from a cough during pregnancy, you may be looking for relief from expectorant medications. But before you take that spoonful, know what types of risks are involved.

Definition

Expectorants are medications that help discharge mucus from the respiratory tract and are used mostly to ease coughing symptoms. Expectorants are sold by prescription and over-the-counter. The most popular cold medications contain expectorants, such as guaifenesin--brand name Humibid L.A.--and dextromethorphan--brand name Benylin DM. Research studies on the effects of these expectorants during pregnancy have had mixed results.

Guaifenesin

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The expectorant guaifenesin has a low risk of causing malformation in a developing fetus, according to the Illinois Teratogen Information Service, or ITIS. But a 1977 study by Heinonen et al., called “Birth Defects and Drugs in Pregnancy,” noted an increased risk of inguinal hernia when pregnant women took guaifenesin during the first trimester. Inguinal hernia is when the testicles of a male fetus develop inside his abdomen.

The use of guaifenesin during the first trimester causes an increased risk of neural tube defects in the presence of febrile illness, according to a 1998 study by Shaw et al., titled “Maternal Illness, Including Fever and Medication Use as Risk Factors for Neural Tube Defects.” A febrile illness is characterized by a sudden onset of fever. A neural tube defect is an abnormality in the formation of the baby’s brain and spinal cord; spina bfida is an example of a neural tube defect.

Dextromethorphan

The expectorant dextromethorphan is safe for use during pregnancy, according to the AAFP. The 1977 study by Heinonen et al. exposed women to dextromethorphan during the first trimester and found no increase in malformations.

This finding was challenged, however, when a 1998 study by Andaloro et al., called “Dextromethorphan and Other N-methyl-D-aspartate Receptor Antagonists are Teratogenic in the Avian Embryo Model,” showed the drug induced miscarriage and caused malformations in chick embryos. The results are controversial because they may not be relevant to humans, according to ITIS.

When to See a Doctor

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Coughing can be a symptom of a wide variety of illnesses from mild to serious. Your cough could be due to a cold or the flu. Other causes include asthma and allergies, congestive heart failure, pulmonary embolism, tuberculosis and lung cancer. Coughing could also result from inhaling irritants such as dust particles, cigarette smoke or chemical fumes.

If you are coughing up pink, frothy mucus and are short of breath, you may have pulmonary adema--fluid in the lungs--and you should go to the nearest emergency room. See your doctor if your cough produces yellow, tan or green mucus--you may have bronchitis or pneumonia. Other symptoms that warrant a trip to a doctor include chest pain, coughing up blood, rapid heartbeat, swelling of the legs, fever and chills.