The effects of pharmacologic agents upon the fetus and newborn

Adamsons, Karlis; Joelsson, Ingemar

doi:10.1016/0002-9378(66)90249-3

Cited by 43 publications

(4 citation statements)

References 173 publications

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“…In this article, our purpose is not to produce another compendium of drugs with known teratogenic effects, suspected teratogenicity, or presumed safety. 12 " 15 We will instead describe the possible pathways of fetal teratogenicity and then review in some detail the evidence for and against the effects on the fetus of commonly used medications during pregnancy.…”

mentioning

confidence: 99%

Effects of Drugs and Chemicals on the Fetus and Newborn (First of Two Parts)

Hill¹,

Kleinberg²

1984

Mayo Clinic Proceedings

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Drug teratogenicity has been demonstrated experimentally for more than 30 years. After the discovery of the thalidomide-induced embryopathies, the fetal dangers of maternal drug ingestion were overemphasized. Accumulation of additional information during the past 15 years has led to a more balanced viewpoint concerning drug teratogenicity. A complex set of circumstances must prevail for a specific teratogenic effect to result. Not only the drug or environmental pollutant in question but also its dose, timing, and frequency of administration as well as the genetic and individual susceptibility of the embryo are important factors. Herein we review the currently available information on drug and environmental effects on the fetus and neonate.

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confidence: 99%

Effects of Drugs and Chemicals on the Fetus and Newborn (First of Two Parts)

Hill¹,

Kleinberg²

1984

Mayo Clinic Proceedings

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“…NALORPHINE, along with pethidine, morphine and heroin, are now the most commonly administered analgesics in labour (Burt, 1971). Although the effects of the narcotics on mothers and fetuses have been extensively studied, clinical interest has been focused mainly on the respiratory depressant effect of these drugs and its reversal by nalorphine (Eckenhoff et al, 1953;Snider, 1954;Schnider and Moya, 1964;Cappe and Pallin, 1954;Chalmers and Thornberry, 1954;Patterson and Prescott, 1954;Woods, 1956;Campbell et al, 1961;Crawford and Rudofsky, 1965;Adamson and Joelsson, 1966;Becketts and Taylor, 1967;Duncan et al, 1969;Krins et al, 1969;Burt, 1971 ;Becketts, 1973), rather than on other possible side effects. However, laboratory and animal studies have shown that the narcotics may have an inhibitory effect on enzymes of oxidative metabolism and oxygen carrying cytochromes (Wang and Bain, 1953;Gurtner and Burns, 1972), they alter fetal placental perfusion by constricting the umbilical blood vessels (Gautieri and Ciuchta, 1962;Gautieri, 1972), and decrease fetal brain oxygenation (Misrahy et al, 1963).…”

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The Effects of Narcotics on Fetal Acid Base Status

Chang

Wood

Humphrey

et al. 1976

BJOG

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Summary This paper reports two randomized control trials on the effects of nalorphine, pethidine, morphine and heroin on fetal and maternal acid base status. The drugs decreased pH and increased pCO2 in the mother, and decreased pH and base excess in the fetus. The changes in the fetus were independent of the changes in the mother. In equivalent dosages, nalorphine increased maternal pCO2 more than pethidine and morphine. The effects of heroin were found to be greater than that of other drugs, and we suggest that heroin should be avoided where the fetus is already at risk.

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“…Neonatal deafness has been recorded following treatment of the mother with streptomycin and its analogues for tuberculosis, but the treatment in these cases has been prolonged and the incidence very low (Adamsons and Joelsson, 1966). In the children studied by Conway and Birt (1965) very large doses of streptomycin given to the mother sometimes produced abnormalities in eighth-nerve function tests, but no cases of perceptive deafness were found.…”

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confidence: 99%