PhD defence E. (Eline) Houben

Summary:

This thesis demonstrates the PHARMO Perinatal Research Network as an invaluable resource for perinatal and paediatric pharmacoepidemiological research. First, a high prevalence of exposure to potentially harmful medication during pregnancy was shown, most notably among vulnerable groups. Also noticeable was the trend towards newer drugs with ill-defined pregnancy risks. These findings on potentially harmful medication use are of sufficient clinical importance to prompt a call towards safer medication management around pregnancy, especially early in pregnancy. Although pregnancy registration by GPs improved over the years, still suboptimal use seems to be made of the available information systems for appropriate drug surveillance. As a second application, the studies presented in this thesis provide evidence for the medical burden of preterm birth continuing into adulthood. It reinforces the need for interventions that can effectively halt labour and decrease clinical sequelae in this vulnerable population. Altogether, it was concluded that collaborative pregnancy care is pivotal, asking for a multidisciplinary approach with key roles for obstetricians, medical specialists, primary care doctors and women themselves. Treating physicians rely on available evidence when making decisions on medication use during pregnancy and daily face difficulties balancing foetal and maternal risks.