Melatonin Use During Pregnancy: Safety and Guidelines

Introduction to Melatonin Safety

The American College of Obstetricians and Gynecologists implies that melatonin may be considered for sleep disorders during pregnancy, starting with the lowest effective dose (1-3 mg), as lower doses may be more effective than higher doses due to receptor saturation concerns 1
The American Academy of Sleep Medicine suggests administering melatonin 1.5-2 hours before desired bedtime for optimal circadian effect 1

The National Institutes of Health recommends choosing United States Pharmacopeial Convention Verified formulations for reliable dosing and purity, as melatonin is regulated as a dietary supplement with variable quality 1, 2
The American College of Obstetricians and Gynecologists advises considering non-pharmacological sleep interventions first, particularly in early pregnancy when organogenesis occurs 2

The American Heart Association recommends using caution in pregnant patients taking warfarin due to potential interactions 2
The Endocrine Society suggests monitoring for impaired glucose tolerance, as melatonin has been associated with this in healthy individuals after acute administration 2
The American Psychiatric Association advises avoiding use if there is personal or family history of psychiatric disorder, as melatonin has been associated with increased depressive symptoms in some individuals 2

The American Diabetes Association states that ACE inhibitors and ARBs are contraindicated during pregnancy due to documented fetal harm 3, 4
The American College of Cardiology recommends that statins should generally be avoided but can be considered in high-risk cases through shared decision-making 3
The American Academy of Pediatrics suggests that ADHD stimulant medications show very low magnitude of documented risks, and consensus supports not stopping them if required for daily functioning 5, 6