Analysis of Nonsteroidal Antiinflammatory Drugs in Meconium and Its Relation to Persistent Pulmonary Hypertension of the Newborn

Abstract

We confirm by meconium analysis the results of previous studies that demonstrated that the use of NSAIDs during pregnancy, particularly aspirin, ibuprofen, and naproxen, is high; is grossly underestimated by maternal history; and is significantly associated with PPHN. Thus, the easy access to over-the-counter NSAIDs of pregnant women should be reevaluated, and the potential dangers of these drugs to the newborn infant should be more effectively promoted.

New approaches for persistent pulmonary hypertension of newborn

“…Recent studies using sensitive analytical techniques to detect drug exposure in utero demonstrated that NSAID exposure is a more frequent association with PPHN than previously recognized [36]. In this study, the presence of ibuprofen and naproxen in the meconium of the infant (implying in utero exposure) and the concentration of these drugs in the meconium correlated with incidence and severity of PPHN [36]. However, the nature of biologic susceptibility that predisposes some but not all infants that had prenatal NSAID exposure to PPHN remains unknown.…”

“…Constriction of the ductus arteriosus leads to a sustained increase in fetal pulmonary artery pressure [34,20], pulmonary vascular remodeling, and failure of vasodilation in response to birth-related stimuli [34,35]. Recent studies using sensitive analytical techniques to detect drug exposure in utero demonstrated that NSAID exposure is a more frequent association with PPHN than previously recognized [36]. In this study, the presence of ibuprofen and naproxen in the meconium of the infant (implying in utero exposure) and the concentration of these drugs in the meconium correlated with incidence and severity of PPHN [36].…”

Persistent Pulmonary Hypertension of the Newborn in Twin-Twin Transfusion Syndrome: A Case-Control Study

“…There is an increased risk in the infants of mothers with asthma, diabetes, or obesity, and also fetal exposure to certain drugs [3]. Known effects are the early closure of the ductus arteriosus due to exposure to non-steroidal anti-inflammatory drugs [4], and pulmonary vascular remodelling due to exposure to selective serotonin re-uptake inhibitors [5,6]. …”

Prescriptions et délivrances d’anti-inflammatoires non stéroïdiens après le 6e mois de grossesse : impact d’une lettre d’information envoyée par les autorités de santé

“…Cette inhibition, à l'origine d'une action vasoconstrictrice, peut être responsable d'effets délétères sur les reins et l'appareil cardiopulmonaire du foetus. Lors d'une consommation de ces médicaments en fin de grossesse, des atteintes rénales, cardiopulmonaires par fermeture prématurée du canal artériel ou des morts foetales in utero et morts néonatales peuvent être une conséquence directe de cette action vasoconstrictrice [4][5][6][7]. Plusieurs cas de toxicité foetale ou néonatale de ce type, faisant suite à une prise d'AINS en fin de grossesse, ont été rapportés par les Centres de pharmacovigilance français et le Centre de référence sur les agents tératogènes [8].…”