Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008

Abstract

Objective To provide information on overall medication use throughout pregnancy, with particular focus on the first trimester and specific prescription medications. Study Design The Slone Epidemiology Center Birth Defects Study (BDS), 1976 to 2008, and the National Birth Defects Prevention Study (NBDPS), 1997 to 2003, which together interviewed over 30,000 women about their antenatal medication use. Results Over the last three decades, first trimester use of prescription medication increased by over 60%, and use of four or more medications more than tripled. By 2008, approximately 50% of women reported taking at least 1 medication. Use of some specific medications markedly decreased or increased. Prescription medication use increased with maternal age and education, was highest for non-Hispanic whites, and varied by state. Conclusion These data reflect the widespread and growing use of medications by pregnant women and reinforce the need to study their respective fetal risks and safety.

Utilização de medicamentos antes e durante a gestação: prevalência e fatores associados

“…Estudo realizado nos Estados Unidos mostrou que, em 2008, 90% das mulheres pesquisadas utilizaram pelo menos um medicamento durante a gravidez 36 ; na Hungria, de acordo com Czeizel 37 , 70% das gestantes foram tratadas com algum medicamento em qualquer período da gestação; trabalhos realizados no Brasil mostraram variação entre 82,9 e 97,4% no uso de pelo menos um medicamento durante a gestação, incluindo vitaminas e suplementos 17,18 . É evidente a grande contribuição de medicamentos recomendados em protocolos pela OMS e pelo Ministério da Saúde, no caso do Brasil, tais como ácido fólico, sulfato ferroso e algumas vitaminas 38 .…”

Medications Used by Pregnant Women: Any Safety Concerns?

“…One of them approached any pregnant woman in the clinic (based on convenience sampling), explained the aim and procedure of the study to these women, and requested their consent to participate in the study. Upon receipt of a verbal consent by the potential respondent, the researcher proceeded to interview her using a structured questionnaire, which was developed based on a previous study [7]. The respondent was also informed that her medical records would be screened to obtain further information on her demographic data and gestational history.…”

“…Pharmacoepidemiological studies are useful in assessing the extent of medication use by pregnant women and to determine the use of potentially teratogenic medications [11]. Such studies have been conducted in countries such as India, Pakistan and the US but are still scarce in Malaysia [7][8]11]. Therefore, the present study was conducted to identify the types of medications used by pregnant women in Malaysia and to evaluate the safety of these medications, particularly during the first trimester of pregnancy.…”

“…Despite the lack of safety data, studies in the US reported an average of 2.6 medications, whilst in North India, 1.7 medications were used during the first trimester of pregnancy, which is the period with high risk of teratogenicity [7][8]. In Malaysia, studies found that 51.4% of pregnant women used at least one type of herbal medication throughout their pregnancy and 73% used such medications during labour, with the hope to shorten and ease their delivery process [9][10].…”

“…Medication use during pregnancy is widespread and should be considered as a cause for public health concern [7][8]11]. Pharmacoepidemiological studies are useful in assessing the extent of medication use by pregnant women and to determine the use of potentially teratogenic medications [11].…”