{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T14:52:31Z","timestamp":1791643951596,"version":"4.3.4"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>The objective of this study was to detect fetal exposure to nonsteroidal antiinflammatory drugs (NSAIDs) by meconium analysis and to determine the relationship between fetal exposure to NSAIDs and the development of persistent pulmonary hypertension of the newborn (PPHN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>In a case-control study of the inborn and outborn nurseries of a large urban medical center, meconium was collected from 101 newborn infants (40 with the diagnosis of PPHN based on clinical or echocardiographic criteria and 61 randomly selected, healthy, term infants [control]) and analyzed for NSAIDs (ibuprofen, naproxen, indomethacin, and aspirin) by gas chromatography\/mass spectrometry. The risk of developing PPHN was determined in infants who were exposed antenatally to NSAID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Infants with PPHN (n = 40) had a mean gestation of 38.9 weeks and birth weight of 3524 g, which were similar to the those of the control group (n = 61). However, the incidence of low Apgar scores (\u22646) at 1 minute and 5 minutes was significantly higher in the PPHN group than in the control group. The diagnoses associated with PPHN were primary PPHN (25%), meconium aspiration syndrome (35%), respiratory distress syndrome (20%), low Apgar score\/asphyxia (12.5%), and pneumonia\/sepsis (8%). Mean duration of ventilator support for the PPHN group was 11 days. Nitric oxide (NO) was given to 19 infants (47.5%) for a mean duration of 25.4 hours. Fourteen of the 19 infants who were treated with NO (74%) required extracorporeal membrane oxygenation, and 2 died. The overall incidence of positive NSAID in meconium in the study population (n = 101) was 49.5%: 22.8% were positive for ibuprofen, 18.8% for naproxen, 7.9% for indomethacin, and 43.6% for aspirin. There was poor agreement (Cohen's \u03ba = 0.09) between maternal history of NSAID use and NSAID detection in meconium. PPHN was significantly associated with 1) the presence of at least 1 NSAID in meconium (odds ratio [OR] = 21.47; 95% confidence interval [CI] = 7.12\u201364.71) or 2) the presence in meconium of aspirin (OR = 8.09; 95% CI = 3.27\u201320.10), ibuprofen (OR = 12.89; 95% CI 3.93\u201342.32), or naproxen (OR = 3.31; 95% CI = 1.17\u20139.33). By logistic regression analysis, low Apgar scores at 1 and 5 minutes and the antenatal exposure to aspirin, naproxen, and ibuprofen were significantly associated with PPHN and treatment with inhaled NO or extracorporeal membrane oxygenation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>We confirm by meconium analysis the results of previous studies that demonstrated that the use of NSAIDs during pregnancy, particularly aspirin, ibuprofen, and naproxen, is high; is grossly underestimated by maternal history; and is significantly associated with PPHN. Thus, the easy access to over-the-counter NSAIDs of pregnant women should be reevaluated, and the potential dangers of these drugs to the newborn infant should be more effectively promoted.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.107.3.519","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"519-523","source":"Crossref","is-referenced-by-count":170,"title":["Analysis of Nonsteroidal Antiinflammatory Drugs in Meconium and Its Relation to Persistent Pulmonary Hypertension of the Newborn"],"prefix":"10.1542","volume":"107","author":[{"given":"Maria Andrea","family":"Alano","sequence":"first","affiliation":[{"name":"1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Ngougmna","sequence":"additional","affiliation":[{"name":"1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Enrique M.","family":"Ostrea","sequence":"additional","affiliation":[{"name":"1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Ganesh","family":"Konduri","sequence":"additional","affiliation":[{"name":"1From the Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2001,3,1]]},"reference":[{"key":"2021121009383611600_B1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0095-5108(18)30903-5","article-title":"Prostaglandin synthesis inhibition in persistent pulmonary hypertension of the newborn.","volume":"3","author":"Turner","year":"1984","journal-title":"Clin Perinatol"},{"key":"2021121009383611600_B2","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0095-5108(18)30902-3","article-title":"Prostaglandins, related compounds, and the perinatal pulmonary circulation.","volume":"11","author":"Philips","year":"1984","journal-title":"Clin Perinatol"},{"key":"2021121009383611600_B3","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1203\/00006450-198903000-00005","article-title":"Ligating the ductus arteriosus before birth causes persistent pulmonary hypertension in the newborn lamb.","volume":"25","author":"Morin","year":"1989","journal-title":"Pediatr Res"},{"key":"2021121009383611600_B4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1203\/00006450-198903000-00006","article-title":"Ligating the ductus arteriosus before birth remodels the pulmonary vasculature of the lamb.","volume":"25","author":"Wild","year":"1989","journal-title":"Pediatr Res"},{"key":"2021121009383611600_B5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1203\/00006450-198711000-00018","article-title":"In vivo constriction of the ductus arteriosus by nonsteroidal antiinflammatory drugs in near term and preterm fetal rats.","volume":"22","author":"Momma","year":"1987","journal-title":"Pediatr Res"},{"key":"2021121009383611600_B6","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1161\/01.RES.38.5.418","article-title":"Effects of acetylsalicylic acid on the ductus arteriosus and circulation in fetal lambs in utero.","volume":"38","author":"Heymann","year":"1976","journal-title":"Circ Res"},{"key":"2021121009383611600_B7","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/0090-6980(75)90064-7","article-title":"Studies on closure of the ductus arteriosus. 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