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Am J Perinatol 2017; 34(06): 541-543
DOI: 10.1055/s-0036-1593845
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transplacental Passage of Acetaminophen in Term Pregnancy

Authors

  • Joshua F. Nitsche

    1   Department of Maternal–Fetal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina

  • Avinash S. Patil

    2   Department of Maternal–Fetal Medicine and Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana

  • Loralie J. Langman

    3   Department of Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota

  • Hannah J. Penn

    4   Department of Neonatology, Mayo Clinic College of Medicine, Rochester, Minnesota

  • Douglas Derleth

    4   Department of Neonatology, Mayo Clinic College of Medicine, Rochester, Minnesota

  • William J. Watson

    5   Department of Maternal–Fetal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota

  • Brian C. Brost

    5   Department of Maternal–Fetal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
Further Information

Publication History

19 June 2016

22 September 2016

Publication Date:
02 November 2016 (online)

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Transplacental Passage of Acetaminophen in Term Pregnancy (Podcast)Am J Perinatol 2017; 34(06): e4-e4
DOI: 10.1055/s-0037-1601384

Abstract

Objective The objective of this study was to determine the maternal and fetal pharmacokinetic (PK) profiles of acetaminophen after administration of a therapeutic oral dose.

Study Design After obtaining Institutional Review Board approval and their written informed consent, pregnant women were given a single oral dose (1,000 mg) of acetaminophen upon admission for scheduled cesarean delivery. Maternal venous blood and fetal cord blood were obtained at the time of delivery and acetaminophen levels were measured using gas chromatography-mass spectroscopy. PK parameters were calculated by noncompartmental analysis. Nonparametric correlation of maternal/fetal acetaminophen levels and PK curves were calculated.

Results In this study, 34 subjects were enrolled (median, 32 years; range, 25–39 years). The median maternal weight was 82 kg (range, 62–100 kg). All but two subjects were delivered beyond 39 weeks' gestation. The median newborn birth weight was 3,590 g (interquartile range, 3,403–3,848 g). Noncompartmental analysis described similar PK parameters in the maternal (T 1/2, 84 minutes; apparent clearance [Cl/F], 28.8 L/h; apparent volume of distribution [Vd/F], 57.5 L) and fetal compartments (T 1/2, 82 minutes; Cl/F, 31.2 L/h; Vd/F, 61.2 L). Paired maternal/fetal acetaminophen levels were highly correlated (p < 0.0001).

Conclusion Fetal acetaminophen PKs in the fetus parallels that in the mother suggesting that placental transfer is flow limited. Maternal acetaminophen levels can be used as a surrogate for fetal exposure.

Keywords

fetal drug exposure - acetaminophen - pregnancy - pharmacokinetics