PregMedNet: Multifaceted Maternal Medication Impacts on Neonatal Complications.

While medication use is common among pregnant women, medication safety remains insufficiently characterized because studies in pregnant women are challenging due to safety concerns. The recent digitization of healthcare databases and advances in computational methods have created new opportunities for large-scale, retrospective drug safety evaluations. Here, we present PregMedNet, a platform that characterizes multifaceted maternal medication effects on neonatal outcomes during pregnancy, covering more than 27,000 drug-disease pairs across 1,152 medications and 24 outcomes. These results encompass known and novel odds ratios (ORs), adjusted ORs, and drug-drug interactions, systematically analyzed using nationwide claims data and an advanced machine learning pipeline. Notably, one of the newly discovered associations was experimentally validated in vivo. This supports the reliability of PregMedNet findings and demonstrates the utility of claims data and machine learning for perinatal medication safety studies. Additionally, potential biological mechanisms underlying the associations were explored using a graph learning method, providing candidate pathways for future mechanistic investigations. We expect that PregMedNet will contribute to advancing maternal medication safety and improving neonatal outcomes by providing extensive, multifaceted drug safety information on this previously underrepresented population.