Psychopharmacoteratophobia: Excessive fear of malformation associated with prescribing psychotropic drugs during pregnancy: An Indian perspective

Implementing a Perinatal Depression Screening in Clinical Routine: Exploring the Patient's Perspective

Introduction Perinatal depression (PND) is a frequently observed mental disorder, showing a prevalence of up to 20% and resulting in unfavorable maternal and neonatal outcomes. Targeted screening for PND offers the potential to identify and treat undiagnosed cases and help prevent its deleterious consequences. The aim of the present study was to evaluate participants' personal attitudes and acceptance of a routine screening program for PND in pregnancy care, identify any potential underlying factors, and appraise the general perspective on perinatal mental health problems. Methods In total, 732 women in their second trimester of pregnancy took part in a PND screening program that was incorporated in routine prenatal care using the Edinburgh Postnatal Depression Scale (EPDS) and completed a web-based survey on screening acceptance. Results Participants viewed PND screening as useful (78.7%, n = 555/705), especially in terms of devoting attention to perinatal mental health problems (90.1%, n = 630/699), easy to complete (85.4%, n = 606/710), and without feelings of discomfort (88.3%, n = 628/711). Furthermore, women with previous or current mental health issues rated the usefulness of screening significantly higher, as did women with obstetric risks (p < 0.01 - p = 0.04). The final regression model explained 48.4% of the variance for screening acceptance. Conclusion Patient acceptance for PND screening was high in our study cohort, supporting the implementation of screening programs in routine pregnancy care with the potential to identify, sensitize, and treat undiagnosed patients to reduce stigmatization and offer access to tailored dedicated PND care programs.

Medication history-wide association studies for pharmacovigilance of pregnant patients

Background

Systematic exclusion of pregnant people from interventional clinical trials has created a public health emergency for millions of patients through a dearth of robust safety data for common drugs.

Methods

We harnessed an enterprise collection of 2.8 M electronic health records (EHRs) from routine care, leveraging data linkages between mothers and their babies to detect drug safety signals in this population at full scale. Our mixed-methods signal detection approach stimulates new hypotheses for post-marketing surveillance agnostically of both drugs and diseases—by identifying 1,054 drugs historically prescribed to pregnant patients; developing a quantitative, medication history-wide association study; and integrating a qualitative evidence synthesis platform using expert clinician review for integration of biomedical specificity—to test the effects of maternal exposure to diverse drugs on the incidence of neurodevelopmental defects in their children.

Results

We replicated known teratogenic risks and existing knowledge on drug structure-related teratogenicity; we also highlight 5 common drug classes for which we believe this work warrants updated assessment of their safety.

Conclusion

Here, we present roots of an agile framework to guide enhanced medication regulations, as well as the ontological and analytical limitations that currently restrict the integration of real-world data into drug safety management during pregnancy. This research is not a replacement for inclusion of pregnant people in prospective clinical studies, but it presents a tractable team science approach to evaluating the utility of EHRs for new regulatory review programs—towards improving the delicate equipoise of accuracy and ethics in assessing drug safety in pregnancy.

Potential Cultivation of Lactobacillus pentosus from Human Breastmilk with Rapid Monitoring through the Spectrophotometer Method

The present study focused on the development of a new method to determine the lag phase of Lactobacillus in breast milk which was attained during the 1st, 3rd, and 6th month (M1, M3, and M6). The colonies’ phylogenetic analysis, derived from the 16S rRNA gene sequences, was evaluated with genus Lactobacillus pentosus and achieved a similarity value of 99%. Raman spectroscopy in optical densities of 600 nm (OD600) were used for six consecutive days to observe the changes of the cell growth rate. The values of OD600 were well fitted with the regression model. From this work, M1 was found to be the longest lag phase in 18 h, and it was 17% to 27% longer compared to M3 and M6, respectively. However, the samples of M3 and M6 showed the shortest duration in reaching 0.5 of OD600 nm (16 h) which was enhanced by 80% and 96% compared to M1, respectively. These studies will be of significance when applied in determining the bacteria growth curve and in assessing the growth behavior for the strain in human breast milk.