Is personalized medicine achievable in obstetrics?

Semin Perinatol. 2014 Dec;38(8):534-40. doi: 10.1053/j.semperi.2014.08.017. Epub 2014 Oct 3.

Abstract

Personalized medicine seeks to identify the right dose of the right drug for the right patient at the right time. Typically, individualization of therapy is based on the pharmacogenomic makeup of the individual and environmental factors that alter drug disposition and response. In addition to these factors, during pregnancy, a woman's body undergoes many changes that can impact the therapeutic efficacy of medications. Yet, there is minimal research regarding personalized medicine in obstetrics. Adoption of pharmacogenetic testing into the obstetrical care is dependent on evidence of analytical validity, clinical validity, and clinical utility. Here, we briefly present information regarding the potential utility of personalized medicine for treating the obstetric patient for pain with narcotics, hypertension, and preterm labor, and discuss the impediments of bringing personalized medicine to the obstetrical clinic.

Keywords: medications; obstetrics; personalized medicine; pharmacogenetics.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antihypertensive Agents / metabolism
  • Antihypertensive Agents / therapeutic use
  • Cytochrome P-450 CYP2C9 / genetics
  • Cytochrome P-450 CYP2C9 / metabolism
  • Cytochrome P-450 CYP2D6 / genetics
  • Cytochrome P-450 CYP2D6 / metabolism
  • Cytochrome P-450 CYP3A / genetics
  • Cytochrome P-450 CYP3A / metabolism
  • Female
  • Glucuronosyltransferase / genetics
  • Glucuronosyltransferase / metabolism
  • Humans
  • Hypertension / drug therapy
  • Narcotics / metabolism
  • Narcotics / therapeutic use
  • Obstetric Labor, Premature / drug therapy
  • Obstetrics*
  • Pain / drug therapy
  • Pharmacogenetics*
  • Precision Medicine*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy
  • Tocolytic Agents / metabolism
  • Tocolytic Agents / therapeutic use

Substances

  • Antihypertensive Agents
  • Narcotics
  • Tocolytic Agents
  • Cytochrome P-450 CYP2C9
  • Cytochrome P-450 CYP2D6
  • Cytochrome P-450 CYP3A
  • UGT1A1 enzyme
  • Glucuronosyltransferase