The Potential Impact of Preemptive Pharmacogenetic Genotyping in the Neonatal Intensive Care Unit

Katherine A Gallaway; Kayla Cann; Katherine Oetting; Mary Rothenberger; Andra Raibulet; James E Slaven; Kristen Suhrie; Emma M Tillman

doi:10.1016/j.jpeds.2023.113489

The Potential Impact of Preemptive Pharmacogenetic Genotyping in the Neonatal Intensive Care Unit

J Pediatr. 2023 Aug:259:113489. doi: 10.1016/j.jpeds.2023.113489. Epub 2023 May 17.

Authors

Katherine A Gallaway¹, Kayla Cann², Katherine Oetting², Mary Rothenberger², Andra Raibulet³, James E Slaven⁴, Kristen Suhrie⁵, Emma M Tillman⁶

Affiliations

¹ Division of Pediatric Critical Care, Indiana University School of Medicine, Indianapolis, IN.
² Purdue University College of Pharmacy, Purdue University, West Lafayette, IN.
³ College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN.
⁴ Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN.
⁵ Division of Neonatology, Department of Pediatrics, and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN.
⁶ Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN. Electronic address: emtillma@iu.edu.

PMID: 37201679
DOI: 10.1016/j.jpeds.2023.113489

Abstract

Objective: To evaluate the use of drugs with pharmacogenomic (PGx) guidelines from the Clinical Pharmacogenetics Implementation Consortium in early childhood.

Study design: A retrospective observational study of patients admitted to the neonatal intensive care (NICU) between 2005 and 2018 with at least 1 subsequent hospitalization at or after 5 years of age was performed to determine PGx drug exposure. Data regarding hospitalizations, drug exposures, gestational age, birth weight, and congenital anomalies and/or a primary genetic diagnosis were collected. Incidence of PGx drug and drug class exposures was determined and patient specific factors predictive of exposure were investigated.

Results: During the study, 19 195 patients received NICU care and 4196 (22%) met study inclusion; 67% received 1-2, 28% 3-4, and 5% 5 or more PGx-drugs in early childhood. Preterm gestation, low birth weight (<2500 g), and the presence of any congenital anomalies and/or a primary genetic diagnosis were statistically significant predictors of Clinical Pharmacogenetics Implementation Consortium drug exposures (P < .01, P < .01, P < .01, respectively).

Conclusions: Preemptive PGx testing in patients in the NICU could have a significant impact on medical management during the NICU stay and throughout early childhood.

Keywords: NICU; genomics; pharmacogenetic; precision medicine.

Publication types

Observational Study

MeSH terms

Child, Preschool
Genotype
Humans
Infant, Low Birth Weight
Infant, Newborn
Intensive Care Units, Neonatal*
Intensive Care, Neonatal
Pharmacogenetics*