Effect of QT interval-prolonging drugs taken in pregnancy on the neonatal QT interval

Michel, Holger and Potapow, Antonia and Dechant, Markus-Johann and Brandstetter, Susanne and Wellmann, Sven and Koeninger, Angela and Melter, Michael and Apfelbacher, Christian and Kabesch, Michael and Gerling, Stephan (2023) Effect of QT interval-prolonging drugs taken in pregnancy on the neonatal QT interval. FRONTIERS IN PHARMACOLOGY, 14: 1193317. ISSN , 1663-9812

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Abstract

Introduction: Acquired QT interval prolongations due to drug side effects can result in detrimental arrhythmia. Maternal use of placenta-permeable drugs may lead to fetal exposure, thus leading to an increased risk of neonatal QT prolongation and arrhythmia.Objectives: This study aimed to evaluate the influence of maternal QT-prolonging medication on the neonatal QT interval.Methods: In the prospective KUNO-Kids health study, an ongoing population-based birth cohort, we classified maternal medications according to the known risk of QT interval prolongation. Effects on the neonatal QT interval were tested by linear regression analyses, correcting for perinatal confounders (birth weight, gestational age, birth mode, and age at ECG recording). Subgroup analyses were performed for selective serotonin reuptake inhibitors, proton pump inhibitors, and antihistamine dimenhydrinate. Logistic regression analysis was performed using a QTc of 450 ms as the cut-off value.Results: A total of 2,550 pregnant women received a total of 3,990 medications, of which 315 were known to increase the risk of QT prolongation, resulting in 105 (4.1%) neonates exposed in the last month of pregnancy. Overall, the mean age of the neonates at ECG was 1.9 days and the mean QTc (Bazett) was 414 ms. Univariate (regression coefficient -2.62, p = 0.288) and multivariate (regression coefficient -3.55, p = 0.146) regression analyses showed no significant effect of fetal medication exposure on the neonatal QT interval, neither in the overall nor in the subgroup analysis. Logistic regression analysis showed no association of exposure to maternal medication with an increased risk of neonatal QT interval prolongation (OR (odds ratio) 0.34, p = 0.14).Conclusion: The currently used maternal medication results in a relevant number of fetuses exposed to QT interval-prolonging drugs. In our cohort, exposure was found to have no effect on the neonatal QT interval.

Item Type: Article
Uncontrolled Keywords: SUDDEN UNEXPLAINED DEATH; PROLONGATION; INFANT; INHIBITORS; LIFE; acquired long QT; neonate; KUNO-Kids; maternal medication; ECG
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Geburtshilfe)
Medicine > Lehrstuhl für Kinder- und Jugendmedizin
Depositing User: Dr. Gernot Deinzer
Date Deposited: 07 Mar 2024 16:39
Last Modified: 07 Mar 2024 16:39
URI: https://pred.uni-regensburg.de/id/eprint/59016

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