The newer or second generation antipsychotics (SGAs) have not been studied in any great detail; to date, to our knowledge, there have been no blinded or randomized studies examining birth outcomes in women taking SGAs, and these are unlikely given ethical considerations. Prescribing guidelines laid out in MIMS (2003) for all current SGAs include pregnancy as a "special precaution" and despite the gravity of associated risks of teratogenesis, there are few publications examining atypical antipsychotic medication use in pregnant women. In their review, Patton and colleagues (2002) cite four studies on the outcome of clozapine use, noting that for a total five cases no congenital abnormalities were reported, although one infant experienced low grade fever and seizure, with gastroesophageal reflux. Grigoriadis and Seeman (2002) suggest that the increased risk of agranulocytosis and seizures in babies, coupled with the identification of both pregnancy and clozapine as potentially increasing the likelihood of thromboembolisms, render this a medication to be avoided during pregnancy. Twenty-three Olanzapine-exposed pregnancies were observed by Goldstein and colleagues (2000), who found there was no increased risk of spontaneous abortion, stillbirth, prematurity or major malformation. The authors were, however, swift to assert that studies of greater sample sizes and over a protracted time period are necessary before olanzapine can be declared "safe" with confidence.