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Neonatal medication surveillance by the pharmacist
Insights
Maternal medication use during pregnancy and childbirth can lead to adverse effects in newborns. Pharmacists should interview mothers about their medication history before delivery to ensure infant safety.
Area of Science:
- Neonatal pharmacology
- Maternal-fetal medicine
- Clinical pharmacy
Background:
- Medication exposure in neonates is a significant concern.
- Understanding drug effects on newborns requires comprehensive maternal and infant data.
- Limited awareness exists among mothers regarding medication impact on fetuses.
Purpose of the Study:
- To assess neonatal exposure to medications during prenatal, labor/delivery, and postnatal periods.
- To identify adverse drug reactions in neonates linked to maternal medication use.
- To evaluate the role of pharmacists in maternal medication management.
Main Methods:
- Prospective study of 100 neonates over 11 weeks.
- Data collection included maternal social/medication history, anesthesia records, and neonatal charts.
- Pharmacist-led interviews and record reviews were conducted.
Main Results:
- 15 adverse drug reactions were identified in 13 neonates.
- Common prenatal exposures included vitamins, iron, analgesics, and antiemetics.
- Oxytocin, meperidine, and promazine were frequently used during labor; narcotics caused respiratory depression.
- Postnatal medications included vitamin K1, gentamicin, and ampicillin.
Conclusions:
- Maternal medication use significantly impacts neonates, with potential for adverse reactions.
- There is a critical need for enhanced maternal awareness of medication risks to the fetus.
- Pharmacist-led medication interviews prior to labor and delivery are recommended to improve safety.
Abstract:
Data on prenatal, labor and delivery, and postnatal medication exposure to neonates were collected. During an 11-week period, 100 neonates consecutively admitted to a hospital were studied. The pharmacist obtained a social and medication history from the mothers and reviewed maternal anesthesia records and the charts of the neonates. Fifteen definite and possible adverse medication reactions were detected in 13 neonates. The median number of different medications ingested prenatally was 4.7. The four most commonly ingested prenatal medications were vitamins (97%), iron preparations (90%), headache/pain/arthritis medications (68%) and antinausea/vomiting medications (40%). The most commonly used medications during labor and delivery were oxytocin (73%), meperidine (33%) and promazine (25%). The use of strong narcotics during this period produced neonatal respiratory depression in some cases. The four most commonly prescribed postnatal medications were vitamin K1 (100%), gentamicin (10%), ampicillin (8%) and Poly-Vi-Sol (6%). The maternal interview indicated that most mothers were unaware of the influence that many medications can play upon the fetus. It is recommended that the pharmacist conduct a maternal medication interview prior to labor and delivery.