Perceptions by pregnant and childbearing-age women in southern Brazil towards teratogenic risk from medicines and radiotherapy

Abstract

Mistaken perception of teratogenic risk can keep pregnant women from using safe medicines. The current study analyzed women’s concepts and perceptions towards teratogenic risk from medicines and exposure to radiotherapy during pregnancy. The quantitative data resulted from interviews with 287 pregnant and non-pregnant women. Two qualitative focus groups were conducted. No significant differences were observed between the two groups in terms of perceptions of teratogenic risk. Median perceptions of non-teratogenic exposures (paracetamol and metoclopramide) were close to the expected values, while higher values were found for teratogenic exposures (misoprostol and radiotherapy). The logic women used to estimate risk was classification of medicines as “strong” or “weak”. Medicines perceived as “weak” by the women do not pose any teratogenic risk, as shown by the median perceptions close to the true values. Meanwhile, “strong” medicines were viewed as dangerous, thus explaining the high median perceptions of teratogenic exposures.

Risk management of teratogenic medicines: A systematic review

“…Two studies out of seven (28.6%) included multiple countries (Lupattelli, Picinardi, Einarson, & Nordeng, 2014;Petersen et al, 2015), and the rest were from Denmark (n = 1; 14.3%) (Gils et al, 2016), Norway (n = 1; 14.3%) (Nordeng, Ystrom, & Einarson, 2010), France (n = 1; 14.3%) (Damase-Michel, Pichereau, Pathak, Lacroix, & Montastruc, 2008), Spain (n = 1; 14.3%) (Sanz et al, 2001), and Brazil (n = 1; 14.3%) (Pons Eda, Pizzol Tda, & Knauth, 2014). All studies had a cross sectional design and were published after the year 2000.…”

“…All studies had a cross sectional design and were published after the year 2000. Four studies out of seven (57.1%) utilized online questionnaires for data collection (Gils et al, 2016;Lupattelli et al, 2014;Nordeng et al, 2010;Petersen et al, 2015), two studies used questionnaires filled during a continuous educational course (Damase-Michel et al, 2008;Sanz et al, 2001), and one study collected data within prenatal services in primary care (Pons Eda et al, 2014). Data were collected using questionnaires in all studies.…”

“…Data were collected using questionnaires in all studies. A numeric scale was used to measure the perception of teratogenic risk in five studies out of seven (71.4%) (Gils et al, 2016;Lupattelli et al, 2014;Nordeng et al, 2010;Petersen et al, 2015;Pons Eda et al, 2014) and a visual analogue scale was used in two studies (28.6%) (Damase-Michel et al, 2008;Sanz et al, 2001). Five studies (71.4%) (Gils et al, 2016;Lupattelli et al, 2014;Nordeng et al, 2010;Petersen et al, 2015;Pons Eda et al, 2014) were of high quality and two (28.6%) were of medium quality (Damase-Michel et al, 2008;Sanz et al, 2001).…”

“…A proper estimation of the teratogenic risk was reported for thalidomide (by general practitioners and obstetric/gynecologists) (Gils et al, 2016), for etretinate (by pregnant women) (Sanz et al, 2001), and for misoprostol (by pregnant and nonpregnant women) (Pons Eda et al, 2014). An under-estimation of the teratogenic risk was reported for warfarin and retinoids (by general practitioners and obstetric/gynecologists) (Gils et al, 2016).…”

“…Two methods were used to measure the perception of teratogenic risk of participants, and those were either a numeric scale (Gils et al, 2016;Lupattelli et al, 2014;Nordeng et al, 2010;Petersen et al, 2015;Pons Eda et al, 2014) or a visual analogue scale (Damase-Michel et al, 2008;Sanz et al, 2001). One major issue regarding the use of a numeric scale to estimate the risk is its dependence on numeracy skills of participants (Peters, Hibbard, Slovic, & Dieckmann, 2007; Pons Eda , 2014).…”