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

Alano, Maria Andrea; Ngougmna, Etienne; Ostrea Jr, Enrique M.; Konduri, G. Ganesh

doi:10.1542/peds.107.3.519

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

Pediatrics, v.107 no.3, 2001년, pp.519 - 523

Alano, Maria Andrea (1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan.) , Ngougmna, Etienne (1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan.) , Ostrea Jr, Enrique M. (1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan.) , Konduri, G. Ganesh (1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan.)

Abstract ▼ AI-Helper

Objective.The objective of this study was to detect fetal exposure to nonsteroidal antiinflammatory drugs (NSAIDs) by meconium analysis and to determine the relationship between fetal exposure to NSAIDs and the development of persistent pulmonary hypertension of the newborn (PPHN).Methods.In a case-control study of the inborn and outborn nurseries of a large urban medical center, meconium was collected from 101 newborn infants (40 with the diagnosis of PPHN based on clinical or echocardiographic criteria and 61 randomly selected, healthy, term infants [control]) and analyzed for NSAIDs (ibuprofen, naproxen, indomethacin, and aspirin) by gas chromatography/mass spectrometry. The risk of developing PPHN was determined in infants who were exposed antenatally to NSAID.Results.Infants with PPHN (n = 40) had a mean gestation of 38.9 weeks and birth weight of 3524 g, which were similar to the those of the control group (n = 61). However, the incidence of low Apgar scores (≤6) at 1 minute and 5 minutes was significantly higher in the PPHN group than in the control group. The diagnoses associated with PPHN were primary PPHN (25%), meconium aspiration syndrome (35%), respiratory distress syndrome (20%), low Apgar score/asphyxia (12.5%), and pneumonia/sepsis (8%). Mean duration of ventilator support for the PPHN group was 11 days. Nitric oxide (NO) was given to 19 infants (47.5%) for a mean duration of 25.4 hours. Fourteen of the 19 infants who were treated with NO (74%) required extracorporeal membrane oxygenation, and 2 died. The overall incidence of positive NSAID in meconium in the study population (n = 101) was 49.5%: 22.8% were positive for ibuprofen, 18.8% for naproxen, 7.9% for indomethacin, and 43.6% for aspirin. There was poor agreement (Cohen's κ = 0.09) between maternal history of NSAID use and NSAID detection in meconium. PPHN was significantly associated with 1) the presence of at least 1 NSAID in meconium (odds ratio [OR] = 21.47; 95% confidence interval [CI] = 7.12-64.71) or 2) the presence in meconium of aspirin (OR = 8.09; 95% CI = 3.27-20.10), ibuprofen (OR = 12.89; 95% CI 3.93-42.32), or naproxen (OR = 3.31; 95% CI = 1.17-9.33). By logistic regression analysis, low Apgar scores at 1 and 5 minutes and the antenatal exposure to aspirin, naproxen, and ibuprofen were significantly associated with PPHN and treatment with inhaled NO or extracorporeal membrane oxygenation.Conclusion.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.

참고문헌 (34)

Clin Perinatol Turner 3 581 1984 10.1016/S0095-5108(18)30903-5 Prostaglandin synthesis inhibition in persistent pulmonary hypertension of the newborn.

상세보기
Clin Perinatol Philips 11 565 1984 10.1016/S0095-5108(18)30902-3 Prostaglandins, related compounds, and the perinatal pulmonary circulation.

상세보기
Pediatr Res Morin 25 245 1989 10.1203/00006450-198903000-00005 Ligating the ductus arteriosus before birth causes persistent pulmonary hypertension in the newborn lamb.

상세보기
Pediatr Res Wild 25 251 1989 10.1203/00006450-198903000-00006 Ligating the ductus arteriosus before birth remodels the pulmonary vasculature of the lamb.

상세보기
Pediatr Res Momma 22 567 1987 10.1203/00006450-198711000-00018 In vivo constriction of the ductus arteriosus by nonsteroidal antiinflammatory drugs in near term and preterm fetal rats.

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Circ Res Heymann 38 418 1976 10.1161/01.RES.38.5.418 Effects of acetylsalicylic acid on the ductus arteriosus and circulation in fetal lambs in utero.

상세보기
Prostaglandins Sharpe 9 585 1975 10.1016/0090-6980(75)90064-7 Studies on closure of the ductus arteriosus. XII. In utero effect of indomethacin and sodium salicylate in rats and rabbits.

상세보기
J Pediatr Levin 92 478 1978 10.1016/S0022-3476(78)80453-3 Morphologic analysis of the pulmonary vascular bed in infants exposed in utero to prostaglandin synthetase inhibitors.

상세보기
Pediatr Res Harker 15 147 1981 10.1203/00006450-198102000-00013 Effects of indomethacin on fetal rat lungs: a possible cause of persistent fetal circulation (PFC).

상세보기
Circulation Levin 60 360 1979 10.1161/01.CIR.60.2.360 Hemodynamic, pulmonary, vascular and myocardial abnormalities secondary to pharmacologic constriction of the fetal ductus arteriosus.

상세보기
Pediatr Res Lock 238 639 1980 Indomethacin-induced pulmonary vasoconstriction in the conscious newborn lamb.
J Pediatr Perkin 96 721 1980 10.1016/S0022-3476(80)80753-0 Serum salicylate levels and right-to-left ductus shunts in newborn infants with persistent pulmonary hypertension.

상세보기
Am J Obstet Gynecol Manchester 126 467 1976 10.1016/0002-9378(76)90640-2 Possible association between maternal indomethacin therapy and primary pulmonary hypertension of the newborn.

상세보기
J Pediatr Rubaltelli 94 161 1979 10.1016/S0022-3476(79)80390-X Effect on neonate of maternal treatment with indomethacin.

상세보기
J Pediatr Csaba 92 484 1978 10.1016/S0022-3476(78)80454-5 Relationship of maternal treatment with indomethacin to persistent fetal circulation syndrome.

상세보기
Arch Dis Child Wilkinson 54 942 1979 10.1136/adc.54.12.942 Persistent pulmonary hypertension and abnormal prostaglandin E levels in preterm infants after maternal treatment with naproxen.

상세보기
Pediatrics Van Marter 97 658 1996 10.1542/peds.97.5.658 Persistent pulmonary hypertension of the newborn and smoking and aspirin and nonsteroidal antiinflammatory drug consumption during pregnancy.

상세보기
Clin Pharmacol Ther Feldman 29 788 1981 10.1038/clpt.1981.112 Salicylate absorption from a bismuth subsalicylate preparation.

상세보기
J Pediatr Ostrea 115 474 1989 10.1016/S0022-3476(89)80860-1 Drug screening of meconium in infants of drug dependent mothers: an alternative to urine testing.

상세보기
Pediatrics Ostrea 89 107 1992 10.1542/peds.89.1.107 Drug screening of newborn by meconium analysis: a large scale, prospective, epidemiologic study.

상세보기
J Pediatr Ostrea 133 513 1998 10.1016/S0022-3476(98)70059-9 Spectrum of gestational exposure to illicit drugs and other xenobiotic agents in newborn infants by meconium analysis.

상세보기
Drugs Heymann 32 16 1986 Non-narcotic analgesics. Use in pregnancy and fetal and perinatal effects.
Am J Obstet Gynecol Niebyl 155 747 1986 10.1016/S0002-9378(86)80012-6 Neonatal outcome after indomethacin treatment for preterm labor.

상세보기
Lancet Goudie 2 1187 1979 10.1016/S0140-6736(79)92411-5 Effect on the fetus of indomethacin given to suppress labour.

상세보기
N Engl J Med Norton 329 1602 1993 10.1056/NEJM199311253292202 Neonatal complications after administration of indomethacin for preterm labor.

상세보기
N Engl J Med Schiff 98 321 1989 The use of aspirin to prevent pregnancy induced hypertension and lower the ratio of thromboxane A2 to prostacyclin in relatively high risk pregnancies.
N Engl J Med Benigni 321 357 1989 10.1056/NEJM198908103210604 Effect of low dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy induced hypertension.

상세보기
N Engl J Med Sibai 329 1213 1993 10.1056/NEJM199310213291701 Prevention of preeclampsia with low dose aspirin in healthy, nulliparous pregnant women.

상세보기
Dev Pharmacol Ther Ostrea 1 163 1980 10.1159/000455532 Tissue distribution of morphine in the newborns of addicted monkeys and humans.

상세보기
Clin Chem Ostrea 34 2372 1988 10.1093/clinchem/34.11.2372a Rapid isolation and detection of drugs in meconium of infants of drug dependent mothers.

상세보기
J Pediatr Ostrea 122 152 1993 10.1016/S0022-3476(05)83509-7 Adaptation of the meconium drug test for mass screening.

상세보기

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