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ORIGINAL RESEARCH article

Front. Public Health
Sec. Children and Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1377070

Do birth outcomes mediate the association between drug use in pregnancy and neonatal metabolic bone disease? A prospective cohort study of 10,801 Chinese women Prenatal drugs and metabolic bone disease

Provisionally accepted
Honglin Jiang Honglin Jiang 1Jialin Guo Jialin Guo 2Jing Li Jing Li 2Chunlin Li Chunlin Li 2Wenchong Du Wenchong Du 3Federico Canavese Federico Canavese 4Feng Xie Feng Xie 5Huajing Li Huajing Li 6Jian Yang Jian Yang 6Hao Ying Hao Ying 2*Jing Hua Jing Hua 2*
  • 1 Fudan University, Shanghai, China
  • 2 Shanghai First Maternity and Infant Hospital, Shanghai, Shanghai Municipality, China
  • 3 Nottingham Trent University, Nottingham, United Kingdom
  • 4 Université de Lille, Lille, Nord-Pas-de-Calais, France
  • 5 shanghai united family hospital, Shanghai, China
  • 6 Aigora technology PTE. LTD, Singapore, Singapore

The final, formatted version of the article will be published soon.

    Background: Prenatal drug use can cause toxicity in bone health in newborns. We aimed to examine whether birth outcomes mediate the association between medication use and neonatal metabolic bone disease (MBD).A prospective cohort of 10,801 pregnant women (17-49 years) and their infants followed at a single center from 1 st January, 2012 to 31 st December, 2021 were included. Based on four single drugs, comprehensive medication use was determined and categorized into three groups using latent class analysis: Group 1 included antibiotics and Furosemide or fewer than two drugs except MgSO4, Group 2 included MgSO4 without antibiotics or Furosemide, and Group 3 encompassed Dexamethasone and antibiotics. Mediation analysis was conducted to assess the mediating effects of prematurity, low birth weight (LBW) and small for gestational age (SGA).Results: There were 138 (1.3%) infants with MBD; 2701 (25%) were born preterm, 1717 (15.9%) had LBW, and 303 (2.8%) were SGA. Pregnant women in Groups 2 and 3 had 2.52 to 14.66 times higher risks of delivering an infant with MBD compared to Group 1. Only LBW showed a significant mediating effect on the association between comprehensive medication use and MBD, with a mediation proportion of 51.8% (45.0%–64.1%, P < 0.001). Conclusions: Comprehensive medication use during pregnancy was associated with an increased risk of neonatal MBD, largely mediated by LBW. Early antepartum monitoring and prevention targeting adverse birth outcomes are necessary to mitigate the risk of MBD.

    Keywords: metabolic bone disease, medication during pregnancy, Birth outcome, prematurity, low birth weight, small for gestational age

    Received: 26 Jan 2024; Accepted: 06 Sep 2024.

    Copyright: © 2024 Jiang, Guo, Li, Li, Du, Canavese, Xie, Li, Yang, Ying and Hua. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hao Ying, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, Shanghai Municipality, China
    Jing Hua, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, Shanghai Municipality, China

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