Case Series of Botulinum Toxin Administered to Pregnant Patients and Review of the Literature

Abstract

Objective: To evaluate a case series of patients who received medically necessary botulinum toxin during pregnancy. Materials and Methods: Retrospective chart review of three patients who underwent repeated intralaryngeal injections of botulinum toxin during pregnancy. Chart reviews were also conducted on the children to further evaluate the safety. Results: No evidence of harm to the mothers or fetuses were found in our series, including data from pregnancy and birth records using standard measures of gestation, APGAR scores, neonatal intensive care unit stay, and time until discharge. Clinical data for 3-5 years were available for the children. No evidence of muscular weakness was noted and all diagnoses were listed. Conclusion: Botulinum toxin injection for functional airway issues was not associated with any adverse effects to the mother or fetus during pregnancy in any of the cases reviewed. We recommend further investigation to evaluate the current contraindication of elective botulinum toxin use in pregnancy.

Pregnancy Outcomes in Patients Exposed to OnabotulinumtoxinA Treatment

“…A literature search of BoNT/A treatment during pregnancy (or up to 3 months prior to conception) for therapeutic or aesthetic indications, which may be inclusive of the pregnancies reported in this analysis, revealed 21 publications describing 109 women and 118 pregnancies. 18,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] Some reports described other BoNT/A products, or did not specify the manufacturer, and we acknowledge the non-interchangeability of these findings. Of the published pregnancies, there was one report of a therapeutic abortion 29 and five reports of spontaneous fetal loss.…”

A review on the history, use, and new developments of abobotulinumtoxinA (Dysport)

“…Another case series in 2020 reported on three patients who became pregnant while being treated with BoNT‐A for spasmodic dysphonia. All patients delivered without complications and the infants had no adverse effects from BoNT‐A treatment 86 . Newman et al report a case of a patient with cervical dystonia who was treated with abobotulinumtoxinA through 4 full‐term pregnancies without complications 87 .…”

A comprehensive review on the history, uses, and safety of onabotulinum toxin type A (Botox)

“…118 Similarly, a retrospective chart review demonstrated no evidence of harm to mothers or fetuses for 3 subjects who received repeated intralaryngeal ONA treatments ranging from 3 to 10 U for functional airway issues. 119…”