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

Pharmacoepidemiology and Drug Safety (Impact Factor: 2.94). 04/2010; 19(4):408 - 417. DOI: 10.1002/pds.1906


PurposeTo 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).ResultsExcluding 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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    • "Although it is difficult to compare because of the divergence in study designs and study populations, the prevalence of 12.5% is low in comparison to similar studies that have been published [4,5,12,13]. An Irish study found a prevalence of 19.5% [13] (2010) and studies from the United States found percentages of women that self-medicated with OTC-medication varying between 92,6% [4] (2003) and 53,6% [5] (1993). "
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    ABSTRACT: Background Over-the-counter-medication (OTC-medication) use during pregnancy can be potentially harmful for the fetus. To successfully counsel the patient it is important to know if the patient is at risk. In this study possible predictors for OTC-medication use were identified and a model was designed to predict OTC-medication use during pregnancy. Methods We performed a post-hoc analysis on data collected for a clustered clinical trial to study a screening strategy for Query fever. Pregnant women under supervision of a midwife were eligible for inclusion. These women filled out questionnaires during their pregnancy and post-partum. These questionnaires were used to determine the prevalence and to select possible predictors for OTC-medication use. These predictors were included in a prediction model using multivariate analysis. The discrimination and calibration of the model were assessed with Receiver Operating Characteristic analysis and the Hosmer and Lemeshow test. Results Of the 1348 women enrolling in the clustered clinical trial, we included 1246 women in this analysis. The prevalence of OTC-medication use was 12.5%. The predictors for OTC-medication use in our cohort were: nulliparity, use of prescription medication, the presence of a comorbidity, Body Mass Index between 26 and 30 kg/m2 and General Practitioner visits. These predictors were used to design a prediction model for OTC-medication use. The area under the Receiver Operating Characteristic-curve of the prediction model was 0.667 (95% CI 0.620-0.714 P<0.001) and the predictive probabilities ranged from 6.6% to 57.4%. The Hosmer and Lemeshow goodness-of-fit test indicated good calibration of the model (P = 0.640). Conclusion It is possible to indicate women at risk for OTC-medication use during pregnancy, using five maternal characteristics that independently contribute to the prediction model. The predictors are easy to estimate and the model is easy to implement in daily practice.
    BMC Public Health 03/2013; 13(1):185. DOI:10.1186/1471-2458-13-185 · 2.26 Impact Factor
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    • "While some studies identified a wide range of characteristics related to medication use, including high education (Donati et al. 2000; Bonassi et al. 1994), smoking (Donati et al. 2000; Bonassi et al. 1994; Cleary et al. 2010), age (Cleary et al. 2010), being single (Cleary et al. 2010), and a first-time mother (Cleary et al. 2010), others do not (Olesen et al. 2006; Nordeng et al. 2001). In a previous Norwegian study, there was no association between sociodemographic and lifestyle factors and use of medications during pregnancy after adjustment for the underlying pain condition (Nordeng et al. 2001). "
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    ABSTRACT: The aim of this work was to study the associations between medication use, fear of childbirth, and maternal mental health. Pregnant women (n = 1,984) were recruited through routine antenatal care at a Norwegian hospital from November 2008 through April 2010. Data were collected by three self-completed questionnaires at pregnancy week 17 and 32 and at 8 weeks postpartum. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ). Symptoms of anxiety were measured by the Hopkins Symptom Checklist (SCL-25) and symptoms of depression by the Edinburgh Postnatal Depression Scale (EPDS). In total, 57.7 % of the women used medications during pregnancy. Analgesics were used by 55.8 % of the women and psychotropic medications by 1.8 %. In all, 7.8 % of the women reported fear of childbirth (W-DEQ >85), the prevalence of anxiety (SCL >18) was 11.8 % and the prevalence of depression (EPDS >13) was 8.1 %. Fear of childbirth was significantly associated with use of psychotropic drugs (OR 3.63; 95 % CI 1.39-9.43) but not with the use of analgesics or medications in general. The presence of symptoms of anxiety or depression increased the magnitude of this association. Fear of childbirth is associated with an increased use of psychotropic medication. This finding could not only be explained by an overlap between fear of childbirth and impaired mental health.
    Archives of Women s Mental Health 04/2012; 15(3):203-9. DOI:10.1007/s00737-012-0278-y · 2.16 Impact Factor
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    Microprocesses and Nanotechnology Conference, 1999. Digest of Papers. Microprocesses and Nanotechnology '99. 1999 International; 02/1999
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