Personalised Perinatal Pharmacology: Therapeutic Drug Monitoring, Pharmacokinetics, and Emerging Therapies in Maternal-Fetal Medicine

Pregnant and lactating women represent one of the most underserved populations in clinical pharmacology. Historically excluded from drug trials, these patients are frequently managed on the basis of limited or extrapolated evidence, resulting in persistent knowledge gaps around the safety, efficacy, and optimal dosing of commonly used therapies. This Research Topic addresses that gap by bringing together research on personalised pharmacological approaches across the perinatal continuum — from conception through the postpartum period — with a focus on improving outcomes for both mother and infant.A core theme of this collection is the application of therapeutic drug monitoring (TDM) and pharmacokinetic (PK) modelling to guide individualised dosing in obstetric and perinatal contexts. Pregnancy induces profound physiological changes that alter drug absorption, distribution, metabolism, and excretion, making standard dosing regimens frequently inadequate. Contributions are welcomed that apply population PK modelling, physiologically based pharmacokinetic (PBPK) approaches, or clinical TDM frameworks to therapies used across obstetric indications — including, but not limited to, progesterone, tocolytics, aspirin prophylaxis, antihypertensives, antimicrobials, and anticoagulants.This Research Topic also highlights the growing role of artificial intelligence, machine learning, and real-world pharmacovigilance data in identifying safety signals, optimising therapeutic regimens, and closing evidence gaps in these vulnerable populations. We welcome translational and clinical research that bridges pharmacological science with maternal-fetal medicine, as well as historical and narrative reviews tracing how perinatal pharmacology standards have evolved over time.We welcome original research, systematic reviews, meta-analyses, and perspective articles addressing, but not limited to, the following themes:Therapeutic drug monitoring and pharmacokinetic modelling in pregnancy and lactationSafety and efficacy of obstetric therapies including tocolytics, progesterone, and aspirin prophylaxisAI and real-world data approaches to perinatal pharmacovigilanceDrug safety knowledge gaps in pregnant and lactating populationsHistorical perspectives on the development of perinatal pharmacology standards Topic editors: Emre Pabuccu, Alfredo Vannacci Source: https://www.frontiersin.org/research-topics/80367/personalised-perinatal-pharmacology-therapeutic-drug-monitoring-pharmacokinetics-and-emerging-therapies-in-maternal-fetal-medicine