Women's perception of risks of adverse fetal pregnancy outcomes: a large-scale multinational survey

Abstract

ObjectiveTo determine pregnant women and new mothers’ perception of risks in pregnancy.Design, settings and participantsThis was a large-scale multinational survey including 9113 pregnant women and new mothers from 18 countries in Europe, North America and Australia.Main outcomesRisk perception scores (0–10) for harmful effects to the fetus were derived for: (1) medicines (over-the-counter medicine and prescribed medicine), (2) food substances (eggs and blue veined cheese), (3) herbal substances (ginger and cranberries) (4) alcohol and tobacco, and (5) thalidomide.ResultsOverall, 80% (6453/8131) of women perceived the risk of giving birth to a child with a birth defect to be ≤5 of 100 births. The women rated cranberries and ginger least harmful (mean risk perception scores 1.1 and 1.5 of 10, respectively) and antidepressants, alcohol, smoking and thalidomide as most harmful (7.6, 8.6, 9.2 and 9.4 out of 10, respectively). The perception varied with age, level of education, pregnancy status, profession and geographical region. Noticeably, 70% had not heard about thalidomide, but of those who had (2692/9113), the risk perception scores were 0.4–0.5 points lower in women below 25 years compared to women aged 26–30 years.ConclusionsIn general, women perceived the risks of giving birth to a child with birth defects low, but there were substantial disparities between women's perceived risks and the actual risks when it comes to over-the-counter agents against nausea and prescribed medication. The study revealed that few women knew of thalidomide, suggesting that the general awareness among women of the teratogenic effects of thalidomide is declining, but it has left a general scepticism about safety of medication in pregnancy. This may have some severe consequences if women are left without medical treatments in pregnancy.

Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records

“…Thus, an international survey of nearly 10,000 women reveals a substantial disparity between women's perceived risks and the actual risks of prescribed medication in pregnancy. 64 In this survey women rated the risks of antidepressants on par with smoking and alcohol and almost as dangerous as thalidomide. 64 Indeed only about 20% of around 5000 women who were prescribed antidepressants before pregnancy continued to receive treatment after 6 weeks of gestation.…”

“…64 In this survey women rated the risks of antidepressants on par with smoking and alcohol and almost as dangerous as thalidomide. 64 Indeed only about 20% of around 5000 women who were prescribed antidepressants before pregnancy continued to receive treatment after 6 weeks of gestation. 35 However, some women may discontinue psychotropic medication in this period because they no longer need it.…”

Reproductive Health and Medication Concerns for Patients With Inflammatory Bowel Disease: Thematic and Quantitative Analysis Using Social Listening (Preprint)

“…Despite this, observational studies note that women -particularly those with CD -have higher rates of voluntary childlessness due to concerns surrounding medication side effects, passing the disease to their offspring, fear of infertility and advice given by treating physicians [7,8]. Moreover, many women perceive medications to be unsafe during pregnancy [9][10][11]. Consequently, women are uncertain about taking medications during pregnancy and many believe that medication use should be highly restricted during pregnancy, even when discontinuing medication use might threaten the health of the mother [10].…”

Characteristics of health behaviours and health status indicators among pregnant women in Slovenia

“…It is also the time when they may consider or reconsider their own health, as well as the health of their future child. Some women may experience a conflict between the management of the two (1).…”

“…Women also make important decisions during pregnancy in terms of other types of exposure, for example, alcohol, smoking and certain food items (1). Many women continue to consume alcohol in pregnancy despite an increasing body of evidence suggesting harm to the foetus (7,8).…”