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Three quarters of women in the Netherlands use some form of medication during pregnancy, but little is known about the appropriate dosages. Research by the Radboudumc, MUMC+ and Lareb Mothers of Tomorrow should change this.
A pregnant woman's body changes to support the growth of her unborn child. These changes also affect the processing of drugs in her body. This can lead to too high or too low a dosage of a drug, possibly with adverse effects on the health of the pregnant woman or her child. Too high a dose creates a risk of poisoning. Too low a dose may make a therapy less effective. However, this aspect is rarely investigated because pregnant women often cannot participate in clinical trials. As a result, very little knowledge is available about how much drug reaches the baby in such cases.
Virtual pregnant women
That is why the Department of Pharmacology and Toxicology at Radboudumc, together with Maastricht UMC+ and Lareb Mothers of Tomorrow, is starting a study on appropriate drug dosages in pregnant women and their babies. The research Model Appropriate Dosages for All Mothers (MADAM) is supported by the Bill & Melinda Gates Foundation. Led by Saskia de Wildt, Rick Greupink and Liesbeth Scheepers (MUMC+), predictive models or 'virtual pregnant women' will be used to determine whether it is necessary to adjust dosages during pregnancy. In addition, they will look in placentas, collected just after delivery, at the extent to which various medications used by a pregnant woman actually reach her child.
Research-based advice
Ultimately, this research should lead to a pregnancy formulary: an international information source in which health care providers can look up specially tested dosage recommendations for pregnant women. An important example for this new source is the Kinderformularium, a website on which doctors and pharmacists in the Netherlands and other European countries can find suitable dosages for children of different ages. Furthermore, it will be mapped out how health care providers and (future) mothers deal with dosages during pregnancy based on this study,
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Pieter Lomans
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