Pharmacogenomics in pregnancy

Semin Perinatol. 2020 Apr;44(3):151222. doi: 10.1016/j.semperi.2020.151222. Epub 2020 Jan 25.

Abstract

Pregnant women frequently take prescription and over the counter medications. The efficacy of medications is affected by the many physiological changes during pregnancy, and these events may be further impacted by genetic factors. Research on pharmacogenomic and pharmacokinetic influences on drug disposition during pregnancy has lagged behind other fields. Clinical investigators have demonstrated altered activity of several drug metabolizing enzymes during pregnancy. Emerging evidence also supports the influence of pharmacogenomic variability in drug response for many important classes of drugs commonly used in pregnancy. Prescribing medications during pregnancy requires an understanding of the substantial dynamic physiologic and metabolic changes that occur during gestation. Pharmacogenomics also contributes to the inter-individual variability in response to many medications, and more research is needed to understand how best to manage drug therapy in pregnant women.

Keywords: Drug metabolism; Drug therapy; Pharmacogenetics; Pharmacogenomics; Pregnancy.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / metabolism
  • Antidepressive Agents / metabolism
  • Antiemetics / metabolism
  • Antihypertensive Agents / metabolism
  • Cytochrome P-450 Enzyme System / genetics*
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug Elimination Routes / genetics
  • Female
  • Humans
  • Pharmaceutical Preparations / metabolism*
  • Pharmacogenetics*
  • Pharmacogenomic Variants
  • Pharmacokinetics
  • Pregnancy / metabolism*
  • Pregnancy / physiology

Substances

  • Analgesics, Opioid
  • Antidepressive Agents
  • Antiemetics
  • Antihypertensive Agents
  • Pharmaceutical Preparations
  • Cytochrome P-450 Enzyme System