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Am J Perinatol 2019; 36(02): 136-140
DOI: 10.1055/s-0038-1661405
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Acetaminophen and Acetylsalicylic Acid Exposure in a Preterm Infant after Maternal Overdose

Leeann Pavlek
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Monica Kraft
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Caitlyn Simmons
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Mary Ryan
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Pavel Prusakov
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Amanda Campbell
2   Medical Scientist Training Program, The Ohio State University College of Medicine, The Ohio State University, Columbus, Ohio
,
Nicklaus Brandehoff
3   Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado
,
Patrick C. Ng
3   Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado
,
Jason Russell
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Steven L. Ciciora
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
,
Omid Fathi
1   Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
› Author Affiliations Funding None.
Further Information

Publication History

15 March 2018

22 May 2018

Publication Date:
26 June 2018 (online)

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Abstract

Here, we review the case of a 26 1/7 weeks' gestation premature female infant born to a mother who intentionally ingested a large quantity of Tylenol, aspirin, quetiapine, and prenatal vitamins. The neonate subsequently had markedly elevated levels of both Tylenol and aspirin when checked on the first day of life. While overall clinically stable, the neonate did demonstrate coagulopathy as evidenced by abnormal coagulation studies. Both poison control and a pediatric gastroenterologist/hepatologist were consulted. She successfully tolerated a course of N-acetylcysteine; her subsequent Tylenol level was markedly decreased and the neonate exhibited no further effects of toxicity. The salicylate level decreased on its own accord. To our knowledge, this is the first report of a neonate at 26 weeks' gestation that has been successfully managed for supratherapeutic concentrations of acetaminophen and acetylsalicylic acid secondary to maternal ingestion. While rare, this case may serve as a reference for the effectiveness of N-acetylcysteine in premature infants in such instances.

Keywords

acetaminophen - aspirin - neonate - premature - toxicity - N-acetylcysteine

Authors' Contributions

All authors listed have contributed to writing and reviewing the manuscript and confirm agreement with the full content of said manuscript. All authors have consented to publication.


 

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