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Epidemiology
Prescriptions filled during pregnancy for drugs with the potential of fetal harm
Article first published online: 13 OCT 2009
DOI: 10.1111/j.1471-0528.2009.02377.x
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 116, Issue 13, pages 1788–1795, December 2009
Additional Information
How to Cite
Kulaga, S., Zagarzadeh, A. and Bérard, A. (2009), Prescriptions filled during pregnancy for drugs with the potential of fetal harm. BJOG: An International Journal of Obstetrics & Gynaecology, 116: 1788–1795. doi: 10.1111/j.1471-0528.2009.02377.x
Publication History
- Issue published online: 11 NOV 2009
- Article first published online: 13 OCT 2009
- Accepted 18 August 2009. Published Online 13 October 2009.
Vol. 117, Issue 3, 373, Article first published online: 12 JAN 2010
- Abstract
- Article
- References
- Cited By
Keywords:
- Embryotoxic;
- fetotoxic;
- prescription drugs;
- Quebec Pregnancy Registry;
- teratogen
Objective To assess the extent of prescriptions filled by pregnant women for drugs with recognised potential of fetal harm, and to document the outcomes of these pregnancies.
Design Cross-sectional study.
Population Quebec Pregnancy Registry.
Methods We identified women who were pregnant during a five-year period and who were insured for prescription medications under the provincial drug plan. We obtained information on prescriptions filled during pregnancy for drugs with known potential of fetal harm.
Main outcome measures Prescriptions filled for study drugs during the first, second and third trimesters of pregnancy; termination of pregnancy (TOP) or delivery, and whether the baby was diagnosed with a major congenital malformation (MCM).
Results Of 109 344 women, 56% filled at least one prescription for a medication during pregnancy; 6.3% filled at least one prescription for a drug known to pose a risk to the fetus. Overall, 47% (95% CI, 45.8–48.2) of pregnancies exposed to drugs under study ended in TOP versus 36.2% (95% CI, 35.9–36.5) of those not exposed; 8.2% (95% CI, 8.0–10.0) of live births were diagnosed with an MCM during the first year of life versus 7.1% (95% CI, 6.9–7.3) of those not exposed.
Conclusions This study documents an important level of prescriptions filled during pregnancy for drugs harmful to the developing fetus. The proportions of both TOPs and babies born with MCMs were elevated compared with the expected values. Clinicians caring for women during pregnancy should conduct a medication inventory prior to a planned pregnancy, or as soon as an unplanned pregnancy is recognised.