Gestation, folate

Cephalexin is considered safe and effective. Nitrofurantoin should not be used after week 37 due to concern for hemolytic anemia in the newborn. Sulfa-containing drugs may increase risk for kernicterus in the newborn and should be avoided during the last weeks of gestation. Folate antagonists, such as trimethoprim, are relatively contraindicated during the first trimester because of their association with cardiovascular malformations. Fluoroquinolones and tetracyclines are contraindicated. 

A deficiency of folate during gestation has been associated with abnormal fetal growth and development. Since most AEDs cause some degree of folate deficiency, it is considered worthwhile to administer folate... 

Folate plays an important role in the development and function of the central nervous system. The high folate levels in cerebrospinal fluid give an indication of its importance. An insufficient folate status during the early weeks of gestation leads to problems with the development of the neural tube. Peri-conceptual folic acid reduces the rate of neural tube defects in the general population, and is the reason for the mandatory folic acid fortification of cereals in the US and Canada. 

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