A prospective study of the pattern of morbidity and medication use during antenatal and perinatal period in mothers of neonates admitted to neonatal intensive care unit of a tertiary care hospital

Authors

  • Anitha P. Department of Pharmacology, Sri Siddhartha Medical College, Tumkur, Karnataka, India
  • H. T. Yashoda Department of Paediatrics, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20184331

Keywords:

Maternal morbidity, Maternal medication use, Neonatal outcome

Abstract

Background: Most drugs taken by pregnant women can cross the placenta (except high molecular weight drugs like heparin) and expose the foetus to pharmacologic and teratogenic effects. The drugs used in the late antenatal and intranatal period may have a potential perinatal and neonatal outcome.

Methods: The pattern of maternal morbidity and drug use was assessed prospectively in 150 consecutive mothers of neonates admitted to NICU. The number of drugs used, therapeutic class, dose, route, frequency and purpose of use were recorded. The efficacy and safety of medications was assessed by neonatal outcome.

Results: The most common maternal morbidity during pregnancy was PIH, eclampsia, hypothyroidism, GDM, PROM, oligohydromnias, anemiaorpolyhydromnias, and 4% (n=6) had more than one complication. Different therapeutic classes of drugs were used as per the prevailing clinical conditions or complications. The total number of drugs used was 26, with an average of 3.68 per subject. AMAs were the most commonly used drugs, chosen empirically and used in combination for prophylaxis or control of infections. Other classes of drugs were used for specific indications. None of the NICU admissions in the present study seem to be related to antenatal or perinatal drug exposure. The treatment outcome was very good in most of the subjects and no drug related adverse events or interactions were observed.

Conclusions: Maternal morbidity and drugs administered to mother play an important role in improving the neonatal outcome.

References

Koren G. Special aspects of perinatal and pediatric pharmacology. In: Katzung BG, Masters SB, Trevor AG, eds. Basic and Clinical Pharmacology. 12th ed. New Delhi: McGraw Hill; 2012:1039-1050.

Satoskar RS, Rege NN, Bhandarkar SD. Drugs, pregnancy and the infant. In: Pharmacology and Pharmacotherpeutics. 22nd ed. Mumbai: Saurabh Printers; 2011:1098-1108.

Uppal R, Chhabra A, Narang A. Pattern of drug use in neonatal intensive care unit. Indian Pediatr. 1998 Jul;35(7):647.

Singh M. Perinatal pharmacology. In: Care of the Newborn. 5th ed. Sagar publications; 1999:76-85.

Sweetman SC, editor. Martindale. In: The Complete Drug Reference. 37th ed. London: Pharmaceutical press; 2011:2178.

Dutta D C. Pharmacotherapeutics in obstetrics. In: Konar H editor. Text book of Obstetrics 6th ed. Calcutta: New Central Book Agency; 2004:498-519.

Sweetman SC, editor. In: Martindale. The Complete Drug Reference. 37th ed. London: Pharmaceutical press; 2011:1827.

Walson PD. Pediatric clinical pharmacology and therapeutics. In: Speight TM, Holford NHG, eds. Avery’s drug treatment 4th ed, Adis press; 1997:127-171.

Theis JG, Koren G. Maternal and Fetal clinical pharmacology. In: Speight TM, G Holford NH, eds. Avery’s drug treatment 4th ed, Adis press;1997:75-126.

World Health Organization. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: Programmatic update 2012. Available at: http://www.whoonline.org. Accessed on 1.07.2013.

de Jongh BE, Locke R, Paul DA, Hoffman M. The differential effects of maternal age, race/ethnicity and insurance on neonatal intensive care unit admission rates. BMC Pregnancy Childbirth. 2012 Dec;12(1):97.

Lisonkova S, Janssen PA, Sheps SB, Lee SK, Dahlgren L. The effect of maternal age on adverse birth outcomes: does parity matter?. J Obstetr Gynaecol Canada. 2010 Jun 1;32(6):541-8.

Yoon HS, Shin YJ, Ki M. Risk factors for neonatal infections in full-term babies in South Korea. Yonsei Med J. 2008 Aug 30;49(4):530-6.

Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Nannini A, Weiss J, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics. 2008 Feb 1;121(2):e223-32.

Ostrea EM, Mantaring JB, Silvestre MA. Drugs that affect the fetus and newborn infant via the placenta or breast milk. Pediatr Clin. 2004 Jun 1;51(3):539-79.

Writer WD, Stienstra R, Eddleston JM, Gatt SP, Griffin R, Gutsche BB, et al. Neonatal outcome and mode of delivery after epidural analgesia for labour with ropivacaine and bupivacaine: a prospective meta-analysis. Br J Anaesthesia. 1998 Nov 1;81(5):713-7.

Sweetman SC, edr. Martindale. The Complete Drug Reference. 37th ed. London: Pharmaceutical Press; 2011:59.

Downloads

Published

2018-10-23

How to Cite

P., A., & Yashoda, H. T. (2018). A prospective study of the pattern of morbidity and medication use during antenatal and perinatal period in mothers of neonates admitted to neonatal intensive care unit of a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 7(11), 2223–2227. https://doi.org/10.18203/2319-2003.ijbcp20184331

Issue

Section

Original Research Articles