After birth events

Before its withdrawal in the UK cisapride was specifically contraindicated in premature babies for up to 3 months after birth, because of the risk of QT interval prolongation (10). Between 1988 and 2000 the Medicines Control Agency received 64 reports of suspected adverse effects of cisapride in children under 13 years, of which two were cases of QT prolongation and two were sudden unexplained deaths. Another 106 cardiovascular events were reported from other countries, including 30 cases of QT prolongation, six cases of ventricular fibrillation or tachycardia, and four sudden unexplained deaths. 

An anaphylactoid reaction in a pregnant woman occurred immediately after the administration of dextran 40 solution (32). The baby was delivered rapidly by cesarean section after the event, and was apparently dead at birth but successfully resuscitated. The case has prompted Barbier and colleagues to report on the safety in general of dextran administered during pregnancy (32). They found information on 32 moderate anaphylactoid reactions associated with severe fetal distress and they advised avoiding preventive fluid preload with dextran in pregnancy. 

There is also the awareness that sensitivity to environmental insult, and subsequent expression of that insult, does not cease with birth. The mammal at term is not a miniature adult a partial list of systems still undergoing differentiation include the nervous, endocrine, urogenital, digestive and immune systems. Expression of an insult incurred utero may not develop until after birth, in the human up to ten years of age for most detected anomalies, but with a latency of 15-30 years for carcinogenic events. 

Matuszczyk, J. V., Silverin, B., Larsson, K. 1990. Influence of environmental events immediate after birth on postnatal testosterone secretion and adult sexual behavior in the male rat. Horm. Behav., 24 450-458. 

For more than a decade, it has been recognized that foetuses mount physiological adaptations to survive adverse events that occur during uterine life. These physiological adaptations become maladaptive and increase disease risk when sustained after birth (Nijland et al., 2008). 

---