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Price HR, Lai D, Kim H, et al. Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue. Toxicol Rep. 2020;7:1311-1318doi: 10.1016/j.toxrep.2020.09.003.
Price, H. R., Lai, D., Kim, H., Wright, T. E., Coughtrie, M. W. H., & Collier, A. C. (2020). Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue. Toxicology reports, 71311-1318. https://doi.org/10.1016/j.toxrep.2020.09.003
Price, Hayley R, et al. "Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue." Toxicology reports vol. 7 (2020): 1311-1318. doi: https://doi.org/10.1016/j.toxrep.2020.09.003
Price HR, Lai D, Kim H, Wright TE, Coughtrie MWH, Collier AC. Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue. Toxicol Rep. 2020 Sep 08;7:1311-1318. doi: 10.1016/j.toxrep.2020.09.003. eCollection 2020. PMID: 33072523; PMCID: PMC7548959.
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Toxicol Rep. 2020 Sep 08;7:1311-1318. doi: 10.1016/j.toxrep.2020.09.003. eCollection 2020.

Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue.

Toxicology reports

Hayley R Price, Dickson Lai, Hugh Kim, Tricia E Wright, Michael W H Coughtrie, Abby C Collier

Affiliations

  1. Faculty of Pharmaceutical Sciences, The University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T1Z3, Canada.
  2. Centre for Blood Research, 2350 Health Sciences Mall, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
  3. Faculty of Dentistry, 2199 Wesbrook Mall, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
  4. Department of Biochemistry and Molecular Biology, The University of British Columbia, 2350 Health Sciences Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
  5. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94115, United States.
  6. Departments of Obstetrics, Gynecology & Women's Health and Psychiatry, University of Hawaii Manoa, Honolulu, HI 96813, United States.

PMID: 33072523 PMCID: PMC7548959 DOI: 10.1016/j.toxrep.2020.09.003

Abstract

BACKGROUND: Nonsteroidal anti-inflammatory drugs are contraindicated in the third trimester of pregnancy due to negative effects including alteration of uteroplacental blood flow, premature ductus arteriosus closure, and adverse effects on the fetal kidney. However, many women are unaware of these risks, and commonly report their use in pregnancy. We aimed to determine if umbilical cord was a reliable matrix for detecting NSAID use, determine incidence of use close to labour, and uncover associations with obstetric/neonatal outcomes.

METHODS: We developed a UHPLC-MS/MS method to simultaneously detect diclofenac, ibuprofen, indomethacin, naproxen, and salicylic acid in plasma and umbilical cord lysate. Using this method, we screened 380 lysates to determine the prevalence of NSAID use. Results were compared to the clinical outcomes in pregnancy using ICD9/10 chart codes (n = 21).

RESULTS: The UHPLC-MS/MS method has excellent linearity, accuracy, and precision in solvent and plasma, but lower sensitivity in umbilical cord lysate. We report a 3 % rate of NSAID ingestion within days of labour - the pharmacokinetically-determined window for active ingestion. There were no significant differences observed for maternal, obstetric, or neonatal outcomes between the NSAID positive group (n = 11) and NSAID negative group (n = 369).

CONCLUSIONS: Because NSAID use in third trimester is contraindicated, even a 3% usage rate is alarmingly high. Based on UHPLC-MS/MS performance of umbilical cord lysate, 3% is likely a conservative estimate. Recent adoption of NSAIDs under clinical supervision to support

© 2020 The Authors.

Keywords: Adverse drug reactions; Analgesics; Analytical chemistry; NSAIDs; Neonatal health; Pregnancy; UHPLC-MS/MS; Umbilical cord

Conflict of interest statement

Dr. Collier declares that she has been a paid consultant for Genentech within the last 5 years. None of that work is related to this research project. The remaining authors report no conflict of inter

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