salicylates and Pregnancy--Prolonged

Salicylates have been the most widely studied of the nonnarcotic analgesics in pregnancy, and in the last 20 years evidence has accumulated indicating that their ingestion in pregnancy may have adverse effects on the mother and her child. Salicylates have been found to reduce the mean birth weight of the offspring in animal studies and in 1 human study. In the third trimester of pregnancy the maternal and fetal effects are mediated through the antiprostaglandin properties of salicylates and include prolongation of gestation and labor, increased blood loss at delivery, and increased perinatal mortality. Bleeding manifestations and withdrawal symptoms in newborn infants are associated with raised fetal blood salicylate levels. These effects of salicylates warrant routine antenatal urinary screening for salicylates in communities known to use them heavily. Adverse maternal or fetal effects form acetaminophen use in pregnancy have not been reported, but formal clinical or epidemiologic studies of its use have not been conducted.

Topics: Abnormalities, Drug-Induced; Acetaminophen; Animals; Birth Weight; Chemical and Drug Induced Liver Injury; Female; Fetal Blood; Fetal Growth Retardation; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Liver; Obstetric Labor Complications; Pregnancy; Pregnancy, Prolonged; Retrospective Studies; Salicylates

6.6% of all Australian patients attending an antenatal clinic were found to be taking salicylate preparations regularly, most commonly in powder form and almost always as self-medication. In this group of salicylate takers there was an increased incidence of anaemia, anti-partum and post-partum haemorrhage, prolonged gestation, complicated deliveries, and perinatal mortality compared with non-takers. These findings suggest that regular salicylate consumption has detrimental effects in pregnancy. Routine antenatal urinary screening for salicylate in pregnancy is recommended.

Topics: Adolescent; Adult; Age Factors; Anemia; Female; Fetal Death; Humans; Infant, Newborn; Obstetric Labor Complications; Parity; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Pregnancy, Prolonged; Prospective Studies; Salicylates; Self Medication; Time Factors; Uterine Hemorrhage

Topics: Adult; Anemia; Female; Humans; Obstetric Labor Complications; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Pregnancy, Prolonged; Prenatal Care; Prospective Studies; Salicylates