Medication use in early pregnancy-prevalence and determinants of use in a prospective cohort of women

Authors

  • Brian J. Cleary MSc, BSc,

    Corresponding author
    1. Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
    2. Department of Obstetrics and Gynaecology, Trinity College Dublin, Republic of Ireland
    3. School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
    • Pharmacy Department, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
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  • Hajeera Butt MBBS, MRCOG, MRCPI,

    1. Department of Obstetrics and Gynaecology, Trinity College Dublin, Republic of Ireland
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  • Judith D. Strawbridge MSc, BSc,

    1. School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
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  • Paul J. Gallagher PhD, BSc,

    1. School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
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  • Tom Fahey FRGCP, MFPHM, MD,

    1. Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
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  • Deirdre J. Murphy MD, MRCOG

    1. Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
    2. Department of Obstetrics and Gynaecology, Trinity College Dublin, Republic of Ireland
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  • None of the researchers have any conflict of interest to declare. No contractual constraints on publishing were imposed by the funding bodies.

Abstract

Purpose

To examine the extent, nature and determinants of medication use in early pregnancy.

Methods

We reviewed early pregnancy medication use, as reported to a midwife at the booking interview, in women delivering between 2000 and 2007 in a large maternity hospital in Dublin, Ireland (n = 61 252).

Results

Excluding folic acid, at least one medication was reported in 23 989 (39.2%) pregnancies. Over the counter (OTC) medications were reported in 11 970 (19.5%) pregnancies, illicit drugs or methadone in 545 (0.9%) and herbal medicines/supplements in 352 (0.58%). FDA category D and X medications were reported by 1532 (2.5%) and 1987 (3.2%) women. Asthma, depression and hypertension were among the most commonly reported chronic medical disorders. Medications with potential for foetal harm were reported by 86 (15.7%) women treated for depression and 68 (20%) women treated for hypertension. Factors associated with reporting the use of medications with potential for foetal harm included unplanned pregnancy (adjusted odds ratio [aOR] 1.31, 95% confidence interval [CI] 1.12–1.52), booking at less than 12 weeks gestation (aOR 1.83, 95%CI 1.58–2.13), being above 25 years of age, unemployed (aOR 2.58, 95%CI 2.03–3.29), nulliparous (aOR 1.41; 95%CI 1.22–1.63), single (aOR 1.28; 95%CI 1.06–1.54) or smoking during pregnancy (aOR 1.96, 95%CI 1.67–2.28).

Conclusions

Women frequently report medication use in early pregnancy. Women and prescribers need to be aware of the lack of pregnancy safety data for many medications, and the need for pre-pregnancy planning. Prescribers should ensure that optimal medications are used when treating women of childbearing potential with chronic medical disorders. Copyright © 2010 John Wiley & Sons, Ltd.

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