Studies on the Detection of Adverse Drug Reactions in the Newborn

Abstract

The drugs taken by 67 consecutive private patients during the last trimester of pregnancy have been analyzed by means of a maternal diary composed of a day-by-day medication record. Each mother took an average of 8.7 drugs during the period of study (three to nine weeks), when the drugs contained in multiple drug combinations are included. An average of 6.9 (80%) of these were taken without medical supervision or knowledge, and 1.8 (20%) were specifically ordered by the doctor. Next to vitamins, the most commonly used drugs were aspirin (69% of patients) and antacids (60% of patients). By using a personal medication record, the intake of drugs including those not ordinarily considered as "medicines" can be assessed in an outpatient population.With few exceptions, each prenatal medication crosses the placenta1 and is there¬ fore potentially capable of produc¬ ing an adverse drug reaction in the infrauterine patient. The possibility of risk is generally accepted, but the extent of fetal exposure to maternal medications has received little attention. Two reports in the literature2,3 and one in the Medical Tribune (4:1-27, 1963) indicate that mothers take an average of four to five medications during pregnancy. This rate may be a minimal estimate, since in these studies the reporting technique either relied on patient memory or failed to include home remedies and other medications not ordered by the physician. See also page 2049.This report presents a method for more complete and accurate record¬ ing of maternal medications. A simple maternal diary was provided to each prospective mother, and she was asked to record all medications. The diary was accepted by the pa¬ tients, and the results suggest a surprisingly high rate of drug in¬ take during the last trimester of pregnancy. MethodsAll patients of a private obstetri¬ cal practice were invited to partici¬ pate in a "medication study" dur¬ ing the last trimester of pregnancy. None of the patients was chronical¬ ly ill, and none gave a history of drug abuse or psychiatric hospitalizations. The only long-term med¬ ication was penicillin G potassium, taken prophylactically by two moth¬ ers with a history of rheumatic fever. Each prospective mother was then issued a medication diary From the departments of medicine (Drs.

Coagulation Studies in Extremely Premature Infants

“…%led at day 15. her infant's platelet function and increase susceptibility to bleeding (7,14), cases 1 and 4 were included in the thriving EPT infants lower, the VIII antigen/activity ratio higher and platelets, factors because platelet function was not Part of this study and neither I1 and VII were no different than in group I infants. infant had clinical signs of bleeding.…”

Early Neonatal Drug Utilization in Preterm Newborns in Neonatal Intensive Care Units

“…Stud ies on the drug utilization profile in pregnant women, newborns and children have been prompted mainly by worries about terato genic or adverse effects [1][2][3][4][5][6][7][8][9][10][11][12], Only few drug surveys focused on the therapies deliv ered to newborn infants in NICUs [13][14][15][16][17] and no specific drug surveillance has been reported to date in premature newborns dur ing their stay in NICUs.…”

Authors’ reply re: Association of intrauterine exposure to aspirin and blood pressure at 7 years of age: a secondary analysis

“…The last question raised in the letter concerns the amount of aspirin administered. During the study period, more than two‐thirds of mothers took aspirin prescribed for fever or headache, and the dosage varied from 650 to 1300 mg . We compared blood pressure of the children at age 7 years of mothers without any aspirin exposure with those whose mothers had experienced at least 7 days of exposure.…”