Lack of Guideline‑Supported Safety Evidence for Citicoline and Piracetam in Pregnancy

Guideline Gaps

• Major clinical guidelines on medication use in pregnancy (including those published in Chest 2012, American Journal of Respiratory and Critical Care Medicine 2003, Annals of the Rheumatic Diseases 2025, and Clinical Microbiology and Infection 2024) do not list citicoline or piracetam as acceptable therapeutic options, indicating that no guideline‑level evidence supports their use in pregnant patients. [1][2][3][4]