Pregnancy and the Newborn

Pregnancy and the first weeks of life represent two physiologic situations in which there is a continual and significant change in the levels of plasma proteins, and it may therefore be necessary to adjust the doses of medications during these times. 

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Mil. Meade, B. W., and Rosalki, S. 6., Serum enzyme activity in normal pregnancy and the newborn. /. Obstet. Gynaecol. Brit. Commonw. 70, 693-700 (1963). 

Figure 54-12 Concentrations of alpha fetoprotein (AFP) in fetal and newborn serum, maternal serum, and amniotic fluid. The maternal serum values are medians calculated from 24,232 pregnancies and the amniotic fluid values are medians calculated from 1544 pregnancies from testing performed at ARUP Laboratories Inc. from January to October 1997.The fetal serum values are from Gitlan. The newborn serum values are from Wu et aU "...

Falth-Magnusson K, Ohman H, Kjellman N-IM Maternal abstention from cow milk and egg in allergy risk pregnancies. Effect on antibody production in the mother and the newborn. Allergy 1987 42 64-73. (Ib)... 

The Role of Magnesium in Pregnancy, for the Newborn, and in Children s Diseases... 

The Canadian Health and Welfare is recommending a minimum intake of 160 pg per day. Milk preparations for newborns should contain 5 pg/100 K cal and is similar for adolescents and adults. An additional 25 pg is recommanded during pregnancy and the total intake should not exceed 1000 pg/day. 

The Interim Report of the People s League of Health in England on Nutrition of Expectant and Nursing Mothers (153) contains data of a large scale nutritional experiment. The investigation which lasted from March 1938 to the end of 1939 was planned to show whether additions of vitamins and minerals would benefit the course of pregnancy and labor and the newborn child. An inquiry into the diet of 6022 expectant mothers... 

Beneficial effects have also been attributed to PAF. In reproduction, PAF secreted by the fertilized egg is instrumental in the implantation of the egg in the uterine wall. PAF is produced in significant quantities in the lungs of the fetus late in pregnancy and may stimulate the production of fetal lung surfactant, a protein-lipid complex that prevents collapse of the lungs in a newborn infant. 

Rh incompatibility may occur when an Rh negative mother carries an Rh-positive fetus. At the time of delivery, a small amount of the baby s Rh-positive blood may gain access to the maternal circulation. In response, the immune system of the mother produces anti-Rh antibodies. During the subsequent pregnancy, the fetus is exposed to these antibodies as they cross the placenta. If this fetus is also Rh-positive, then the anti-Rh antibodies attack the fetal erythrocytes and cause hemolytic disease of the newborn (erythroblastosis fetalis). This may occur in about 3% of second Rh-positive babies and about 10% of third Rh-positive babies. The incidence continues to increase with subsequent pregnancies. 

Heptachlor epoxide was found in whole blood samples from nonoccupationally exposed mothers and their newborns in Argentina (Radomski et al. 1971a). The average level of heptachlor epoxide was 0.23 0.29 ppb in 13 mothers and 0.06 0.01 ppb in 13 newborn infants, although no blood samples were taken from the mothers during pregnancy (Radomski et al. 1971a). 

There are many examples of systems for which one or more important responses were unknown. One of the most tragic involved the drug thalidomide. It was known that one of the responses thalidomide produced when administered to humans was that of a tranquilizer it was not known that when taken during pregnancy it would also affect normal growth of the fetus and result in abnormally shortened limbs of the newborn. 

Failure to synthesise sufficient surfactant or the synthesis of abnormal surfactant, so that surface tension cannot be lowered, may play a role in several conditions respiratory distress syndrome of the newborn sudden infant death ( cot death ) and adult respiratory distress syndrome. The enzymes involved in the synthesis of surfactant only appear during the third trimester of pregnancy, so that surfactant is not produced in premature babies and they have difficulty breathing. 

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