Pregnancy category mnemonic

It seems that most of us in the Sydney Medical School have become suckers for mnemonics… Recently, after the Problem 4.05 theme session on drugs in pregnancy, I came up with a mnemonic to help people remember the Australian Drug Evaluation Committee (ADEC) pregnancy categories used for medications in Australia.

Category A = A-OK – generally considered safe
Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed. (ADEC, 2007)
Category C = Careful – may be harmful
Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details. (ADEC, 2007)
Categories B = Buggered if I know – limited data available
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. (The allocation of a B category does NOT imply greater safety than the C category.) (ADEC, 2007)
Category D = Danger – risk of irreversible harm
Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details. (ADEC, 2007)
Category X = X-men – high-risk teratogens
Drugs which have such a high risk of causing permanent damage to the fetus that they should not be used in pregnancy or when there is a possibility of pregnancy. (ADEC, 2007)

Of course the use of drugs in pregnancy requires more than simply looking-up the ADEC pregnancy category, but the categorisation does prove quite useful as a quick reference in clinical practice.