Clinical, Toxicological and Environmental Aspects of Maternal and Child Health in the Light of Gender and Age Differences

Dear Colleagues,

Some women will have or will develop psychiatric diseases during pregnancy, while other pregnant women are subjected to harmful environmental stimuli at work or external environments, and others are smokers or substances abusers. Taking psychotropics during gestation can lead to adverse perinatal and postnatal outcomes; however, psychotherapy in these women to stop medication presents new risks associated with untreated or inadequately treated mental illnesses, such as poor antenatal care, inadequate nutrition and increased use of alcohol and tobacco. However, all psychotropic drugs, numerous environmental toxicants and substances of abuse can cross the placenta, are present in the amniotic fluid, and can enter breast milk. The FDA, the Australian Drug Evaluation Committee and Micromedex, have classified drugs according to risk during pregnancy, but little has been done to study and produce drugs tailored for women, pregnant women and infants and adolescents. For example, on the basis of these classifications, benzodiazepines have been shown to be possibly teratogenic; however, they are still used for the treatment of anxiety, panic, seizures and insomnia. The International Pharmacopoeia reported an increased risk of intrauterine growth retardation, hypotonia, bradycardia, respiratory depression, a low Apgar score and preterm delivery for pregnant women taking fetal plasma drug concentrations equivalent to the therapeutic range of the maternal prescription. Very few data on sudden intrauterine death (SIUD) from intrauterine exposure to psychotropic drugs have been published. Most of the new drugs placed on the market are exclusively tested on a man of average age, male sex and normal weight, but maternal–fetal health and healthy childhood and adolescence are not protected in this way. Chemical and environmental toxicants’ effect on pregnant women also warrants detailed investigation.

Dr. Beatrice Paradiso
Dr. Giulia Ottaviani
Guest Editors

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