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Pregnant pause: is that drug safe for baby?

March 11, 2019 — 

Most first-time mothers have a lot of questions about their pregnancies.

When it comes to things like diet and exercise, the answers are straightforward.

But when it comes to questions about whether it’s okay to keep taking a medication they’ve been on, that’s when Dr. Sherif Eltonsy says responses can get a little fuzzy.

“In a lot of cases, we don’t really know,” said Eltonsy, who joined the College of Pharmacy as an assistant professor in January 2019. That’s because when pharmaceuticals reach the testing stages, pregnant women are rarely part of any trials. And just because a drug is safe for adult men and women, it doesn’t necessarily follow that it’s safe for the health of a fetus.

“In many cases, physicians have to go with their best guess,”” said Eltonsy. “There is little data about the effects.”

For many women, that’s just not good enough. And stopping a medication cold? “That can be very dangerous,” he said.

That’s why he and a research team launched a study in Montreal, using existing data on over 10,000 pregnant women who had chosen to continue using their asthma medication.

“My research mainly uses real-word data,” he says, referring to information that comes from medications already on the market and in use by patients. “We check the data – are there any red flags?”

While asthma is not typically fatal in otherwise healthy patients, poorly managed asthma during pregnancy can create complications such as high blood pressure or preeclampsia, as well as restricted fetal growth or even premature birth.

For these women and their physicians, continuing a prescription – either corticosteroids or long-acting beta agonists in this case – turned out to be a safe choice, both for the mother and the fetus.

“A study like this takes away the uncertainty,” said Eltonsy. “It tells clinicians and patients that this is a good option, that they don’t need to be afraid.”

Born and raised in Cairo, Egypt, he came to Canada in 2008 to pursue graduate studies at the University of Montreal. He received his master’s in pharmaceutical sciences in 2011 and his PhD in pharmaceutical sciences in 2016, both in pharmacoepidemiology and population health.

He became interested in medication safety during pregnancy while working with a colleague at the Université de Montreal and soon found himself hooked. “There is not a lot of work being done in this area,” said Eltonsy. “It’s challenging. And it makes me happy knowing that we provided evidence that helped clinicians and patients.”

Following the success of his research on asthma medication, Eltonsy is preparing to launch a much larger project, using data from across Canada to review the safety of epilepsy medication. “We’re rich here in terms of the data and the population we can work with in Manitoba,” he said, excited about continuing his work in Winnipeg and across the country. “And what I’ve seen here from the staff and my colleagues, it’s phenomenal. I’m really happy to be here.”

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