Medication Safety Mission

“Is this medication safe for my unborn baby?”

It’s a question that doctors should be able to answer for pregnant patients, says Dr. Sherif Eltonsy, assistant professor in the College of Pharmacy.

But for many prescription drugs, there’s a lack of research on the risks of prenatal exposure.

“When new medications are tested through clinical trials, pregnant people are excluded,” Eltonsy says. “That’s why it’s so important that we study health-care databases to observe real-world effects.

“By examining anonymized data for hundreds of thousands of pregnancies, we can detect any associations between a particular drug and adverse outcomes such as congenital malformations, preterm birth or low birth weight.”

There are always new medications that could pose risks, the professor adds. “A recent example is Ozempic, which is popular as a weight-loss drug. What is the safety of Ozempic in pregnancy? Right now, there’s zero data.”

Eltonsy is a pharmacoepidemiologist – a scientist who studies the use, safety and effectiveness of drugs in large populations. “This is my lab,” he says, gesturing at his computer.

Raised in Cairo, Egypt, Eltonsy earned his first degree in pharmaceutical sciences in his home country. Fluent in French, he completed his master’s and PhD at Université de Montréal and did postdoctoral work in New Brunswick. He joined UM in 2019 and is also a researcher with the Children’s Hospital Research Institute of Manitoba.

Eltonsy studies drug effects in many patient groups, such as people with HIV or Parkinson’s disease. But he has a particular interest in the pregnant population, and in adverse health effects in children that may be traceable to drug exposure in the womb.

One of his studies, published in 2015 in the Journal of Allergy and Clinical Immunology, looked at data for more than 4,600 asthmatic mothers in Quebec who used different types and doses of asthma medication during their first trimester.

The results showed that either corticosteroids with long-acting beta agonists or higher doses of corticosteroids were similarly safe for mother and fetus.

In 2021, a team co-led by Eltonsy received $2.9 million from the Canada Foundation for Innovation to create a national harmonized database for this kind of research. The project, the Canadian Mother-Child Cohort Active Surveillance Initiative, aims to quantify the risks and benefits of prescription drug use during pregnancy on short- and long-term maternal and child health.

“This project is one of a handful of its kind in the world. It’s expected to provide insights that were not possible before in Canada,” Eltonsy says.

“We’re currently combining data from Quebec, Manitoba, Saskatchewan, Ontario and Alberta into a massive data set representing more than four million mother-child pairs. This much larger cohort will allow us to spot red flags faster.”  

The first results, reflecting four provinces’ data, revealed that 61 per cent of pregnant women took prescription medication. The most commonly taken drugs were antibiotics for infections, anti-nausea drugs, asthma medications and antidepressants.

“We want to investigate more medications that we know little about, but pregnant women use frequently,” Eltonsy says. “I’m interested in studying drugs for neurological conditions, such as epilepsy.

“Believing that our research can improve the health and quality of life of mothers and children is our big motive.”