Maternal Inhaled Fluticasone Propionate Intake During Pregnancy is Detected in Neonatal Cord Blood

Abstract

Background: Despite recommendations to use inhaled corticosteroids as treatment to control asthma during pregnancy, it is unknown whether inhaled fluticasone propionate (FP) reaches the fetus. Results & methodology: We collected maternal blood on the morning following delivery. FP was detected by ultra-performance LC–MS/MS (UPLC–MS/MS) in 9/17 asthmatic women using FP. Delay between last FP inhalation and maternal blood sampling ranged between 3 and 33 h and FP was detected in a range of 1.572–46.440 pg/ml. Among the nine offspring of these FP users, FP was detected in five cord blood samples. Delay between last predelivery FP inhalation and cord blood sampling ranged from 4 to 20 h and FP was detected in a range of 0.423–4.510 pg/ml. Conclusion: Our findings demonstrate placental passage of inhaled FP.

Keywords::

• asthma
• cord blood
• fluticasone propionate
• pregnancy
• UPLC–MS/MS

Financial & competing interests disclosure

This study was conducted at the CR-CHUS which is a ‘Fonds de Recherche du Québec - Santé’ (FRQS) supported research center. This study was supported by ‘Le Réseau Québécois de Recherche sur les Médicaments’. A Bérard holds a “Chaire FRQ-S” on Medications and Pregnancy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Acknowledgements

The authors acknowledge the Blood Sampling in Pregnancy clinic at the Research Center of the CHUS (CR-CHUS); the assistance of clinical research nurse Maude Gérard and research assistants (M-A Hudon, E Kina, J Moreau) for recruiting women and obtaining their consent; and the CHUS laboratory for performing blood ACTH, cortisol, osteocalcin and DHEA-S analyses. The authors are also grateful to Waters Corporation for their continued scientific support and partnership throughout the years in C Auray-Blais’ laboratory.