Striving for balance in decisions on antenatal pharmacotherapy

Koldeweij, Charlotte, Jans, Verna AAM, Waitt, Catriona ORCID: 0000-0003-0134-5855, Greupink, Rick, Auweele, Kim LHE Vanden, Franklin, Bryony D, Scheepers, Hubertina CJ and de Wildt, Saskia N (2024) Striving for balance in decisions on antenatal pharmacotherapy The Lancet, 404 (10464). pp. 1779-1782. ISSN 0140-6736, 1474-547X

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Abstract

Most individuals use medication during pregnancy. However, decision making on antenatal pharmacotherapy presents considerable ethical and scientific challenges. Amid a sociocultural paradigm prioritising the elimination of fetal risks, available evidence and guidance are limited, and current decision making on antenatal drugs mostly proceeds in an ad-hoc and, often, biased manner. This approach might undermine the health of both mother and child. The need for a systematic approach towards antenatal drug decisions is becoming even more pressing with the growing knowledge of pregnancy-induced changes in drug disposition and effects. With this new complexity, pregnancy-specific doses might be necessary, potentially altering the balance between maternal and fetal benefits and risks. In this Viewpoint, we argue that ethical principles and a pregnant individual's values must be integrated alongside existing evidence when making decisions on antenatal drug use and dosing. We use the example of sertraline to outline practical strategies for achieving this goal. This approach is urgently needed to foster better-informed and balanced decisions on antenatal pharmacotherapy.

Item Type:	Article
Uncontrolled Keywords:	Humans, Pregnancy Complications, Sertraline, Antidepressive Agents, Prenatal Care, Decision Making, Pregnancy, Female
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	04 Nov 2024 09:01
Last Modified:	28 Feb 2026 20:40
DOI:	10.1016/s0140-6736(24)02069-5
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3187016
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