Investigation of medication use patterns among pregnant women attending a tertiary referral hospital

Year 2022, , 90 - 95, 28.04.2022

Berna Terzioğlu Bebitoğlu , Seyhan Hıdıroğlu , Reyhan Ayaz , Alican Sarısaltık , Derya Koç

https://doi.org/10.26650/IstanbulJPharm.2022.980889

Abstract

Background and Aims: Medication use during pregnancy presents a challenge and concern for pregnant women and health- care providers. The aim of this study was to explore patterns and factors associated with medication use by pregnant women. Methods: This cross-sectional study was performed in a gynecology and obstetrics outpatient clinic of a tertiary referral hospital in Turkey. Data were collected by a questionnaire between October 2019 and January 2020. The questionnaire was consisted of 35 questions about participants’ attitudes towards the use of medication. The sociodemographic features, medi- cation and herbal product use during the current pregnancy, and participants’ attitudes towards the use of medication were investigated.
Results: A total of 485 pregnant women were included in the study. The prevalence of using at least one medication during the current pregnancy was 45.6%, whereas herbal product use was 3.9%. Overall, 10.5% of participants used medication to treat chronic/long-term diseases before pregnancy. The most frequently used drugs were agents for nervous system (32.8%), followed by anti-infective drugs (20.8%) and agents for the alimentary tract and metabolism (19.2%). Participants with uni- versity degree or higher education, who had chronic disease before pregnancy, who had one or more previous pregnancies, who had a planned current pregnancy, who were in the second or third trimester, and who were unemployed were likely to use at least one medication.
Conclusion: Medication use is common in pregnancy and is associated with several maternal factors. The factors affecting medication use during pregnancy should be considered in order to incorporate them into clinical pharmacy practice when treating groups that need to be followed more closely in terms of drug use.

Keywords

Medication use, Pregnancy, Prevalence, Herbal product

References

• Araujo, M., Hurault-Delarue, C., Sommet, A., Damase-Michel, C., Benevent, J., & Lacroix, I. (2021). Drug prescriptions in French pregnant women between 2015 and 2016: A study in the EGB database. Therapie, 76(3), 239–247. https://doi.org/10.1016/j. therap.2020.07.002
• Baggley, A., Navioz, Y., Maltepe, C., Koren, G., & Einarson, A. (2004). Determinants of women’s decision making on whether to treat nausea and vomiting of pregnancy pharmacologically. Jour- nal of Midwifery & Women’s Health, 49(4), 350–354. https://doi. org/10.1016/j.jmwh.2004.03.011
• Bánhidy, F., Lowry, R. B., & Czeizel, A. E. (2005). Risk and benefit of drug use during pregnancy. International Journal of Medical Sci- ences, 2(3), 100–106. https://doi.org/10.7150/ijms.2.100
• Bedewi, N., Sisay, M., & Edessa, D. (2018). Drug utilization pattern among pregnant women attending maternal and child health clinic of tertiary hospital in eastern Ethiopia: Consideration of toxicological perspectives. BMC Research Notes, 11, Article 858. https://doi.org/10.1186/s13104-018-3966-5
• Coren, G. (2007). Medication Safety in Pregnancy and Breastfeeding(Vol. 1st Edition). New York, NY: McGraw-Hill.
• Czeizel, A. E. (1999). Ten years of experience in periconceptional care. The European Journal of Obstetrics & Gynecology and Repro- ductive Biology, 84(1), 43–49. https://doi.org/10.1016/s0301- 2115(98)00246-2
• Erebara, A., Bozzo, P., Einarson, A., & Koren, G. (2008). Treating the common cold during pregnancy. Canadian family physician Me- decin de famille canadien,, 54(5), 687–689. Retrieved from https:// pubmed.ncbi.nlm.nih.gov/18474699/
• Florio, K. L., DeZorzi, C., Williams, E., Swearingen, K., & Magalski, A. (2021). Cardiovascular Medications in Pregnancy: A Primer. Cardiol- ogy clinics, 39(1), 33–54. https://doi.org/10.1016/j.ccl.2020.09.011
• Glover, D. D., Amonkar, M., Rybeck, B. F., & Tracy, T. S. (2003). Pre- scription, over-the-counter, and herbal medicine use in a rural, obstetric population. American Journal of Obstetrics and Gynecol- ogy, 188(4), 1039–1045. https://doi.org/10.1067/mob.[phone]
• Holst, L., Wright, D., Haavik, S., & Nordeng, H. (2009). The use and the user of herbal remedies during pregnancy. Journal of Alter- native and Complementary Medicine, 15(7), 787–792. https://doi. org/10.1089/acm.2008.0467
• Kebede, B., Gedif, T., & Getachew, A. (2009). Assessment of drug use among pregnant women in Addis Ababa, Ethiopia. Phar- macoepidemiology and Drug Safety, 18(6), 462–468. https://doi. org/10.1002/pds.1732
• Kıssal, A., Çevik Güner, Ü., & Batkın Ertürk, D. (2017). Use of herb- al product among pregnant women in Turkey. Complemen- tary Therapies in Medicine, 30, 54–60. https://doi.org/10.1016/j. ctim.2016.11.001
• Lacroix, I., Hurault, C., Sarramon, M. F., Guitard, C., Berrebi, A., Grau, M., Albouy-Cossard, C., Bourrel, R., Elefant, E., Montastruc, J. L., & Damase-Michel, C. (2009). Prescription of drugs during preg- nancy: a study using EFEMERIS, the new French database. Euro- pean Journal of Clinical Pharmacology, 65(8), 839–846. https://doi. org/10.1007/s00228-009-0647-2
• Lapi, F., Vannacci, A., Moschini, M., Cipollini, F., Morsuillo, M., Gallo, E., ... & Mugelli, A. (2010). Use, Attitudes and Knowledge of Complementary and Alternative Drugs (CADs) Among Pregnant Women: a Preliminary Survey in Tuscany. Evidence-Based Comple- mentary and Alternative Medicine: eCAM, 7(4), 477–486. https:// doi.org/10.1093/ecam/nen031
• Lee, E., Maneno, M. K., Smith, L., Weiss, S. R., Zuckerman, I. H., Wu- toh, A. K., & Xue, Z. (2006). National patterns of medication use during pregnancy. Pharmacoepidemiology and Drug Safety, 15(8), 537–545. https://doi.org/10.1002/pds.1241
• Lupattelli, A., Spigset, O., Twigg, M. J., Zagorodnikova, K., Mård- by, A. C., Moretti, M. E., ... & Nordeng, H. (2014). Medication use in pregnancy: a cross-sectional, multinational web-based study. BMJ Open, 4(2), e004365. https://doi.org/10.1136/bmjo- pen-2013-004365
• McCarter-Spaulding, D. E. (2005). Medications in pregnancy and lactation. MCN. The American Journal of Maternal Child Nurs-ing, 30(1), 10–19. Retrieved from https://pubmed.ncbi.nlm.nih. gov/15622140/
• Mitchell, A. A., Gilboa, S. M., Werler, M. M., Kelley, K. E., Louik, C., & Hernández-Díaz, S. (2011). Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. American Journal of Obstetrics and Gynecology, 205(1), 51.e51–58. https:// doi.org/10.1016/j.ajog.2011.02.029
• Mulder, B., Bijlsma, M. J., Schuiling-Veninga, C. C., Morssink, L. P., van Puijenbroek, E., Aarnoudse, J. G., ... & de Vries, T. W. (2017). Risks versus benefits of medication use during pregnancy: what do women perceive? Patient Preference and Adherence, 12, 1–8. https://doi.org/10.2147/PPA.S146091
• Navaro, M., Vezzosi, L., Santagati, G., Angelillo, I. F., & Collabora- tive Working Group (2018). Knowledge, attitudes, and practice regarding medication use in pregnant women in Southern Italy. PloS One, 13(6), e0198618. https://doi.org/10.1371/journal. pone.0198618
• Nordeng, H., & Havnen, G. C. (2004). Use of herbal drugs in pregnan- cy: a survey among 400 Norwegian women. Pharmacoepidemiology and Drug Safety, 13(6), 371–380. https://doi.org/10.1002/pds.945
• Nordeng, H., Ystrøm, E., & Einarson, A. (2010). Perception of risk regarding the use of medications and other exposures during pregnancy. European Journal of Clinical Pharmacology, 66(2), 207– 214. https://doi.org/10.1007/s00228-009-0744-2
• Odalovic, M., Vezmar Kovacevic, S., Ilic, K., Sabo, A., & Tasic, L. (2012). Drug use before and during pregnancy in Serbia. Inter- national Journal of Clinical Pharmacy, 34(5), 719–727. https://doi. org/10.1007/s11096-012-9665-8
• Odalovic, M., Vezmar Kovacevic, S., Nordeng, H., Ilic, K., Sabo, A., & Tasic, L. (2013). Predictors of the use of medications before and during pregnancy. International Journal of Clinical Pharmacy, 35(3), 408–416. https://doi.org/10.1007/s11096-013-9750-7
• Palmsten, K., Hernández-Díaz, S., Chambers, C. D., Mogun, H., Lai, S., Gilmer, T. P., & Huybrechts, K. F. (2015). The Most Commonly Dispensed Prescription Medications Among Pregnant Women Enrolled in the U.S. Medicaid Program. Obstetrics & Gynecology, 126(3), 465–473. https://doi.org/10.1097/aog.0000000000000982
• Thorpe, P. G., Gilboa, S. M., Hernandez-Diaz, S., Lind, J., Cragan, J. D., Briggs, G., Kweder, S., Friedman, J. M., Mitchell, A. A., & Hon- ein, M. A. (2013). Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk. Pharmacoepidemiology and Drug Safety, 22(9), 1013–1018. https://doi.org/10.1002/pds.3495
• Tiran, D. (2005). Complementary therapies in maternity care: personal reflections on the last decade. Complementary Thera- pies in Clinical Practice, 11(1), 48–50. https://doi.org/10.1016/j. ctnm.2004.07.002
• Undela, K., Joy, N., Gurumurthy, P., & Sujatha M S. (2021). Knowl- edge, beliefs, and practice of pregnant women regarding medi- cation use during pregnancy: a hospital-based cross-sectional study. Journal of Obstetrics and Gynaecology: The journal of the Institute of Obstetrics and Gynaecology, 41(4), 522–526. https://doi. org/10.1080/01443615.2020.1754368
• World Health Organization (2020). Anatomical Therapeutic Chemical (ATC) Classification [Pdf file]. Retrieved from https:// www.who.int/tools/atc-ddd-toolkit/atc-classification.
• Zafeiri, A., Mitchell, R. T., Hay, D. C., & Fowler, P. A. (2021). Over-the- counter analgesics during pregnancy: a comprehensive review of global prevalence and offspring safety. Human Reproduction Update, 27(1), 67–95. https://doi.org/10.1093/humupd/dmaa042
• Zaki, N. M., & Albarraq, A. A. (2014). Use, attitudes and knowledge of medications among pregnant women: A Saudi study. Saudi Pharmaceutical Journal, 22(5), 419–428. https://doi.org/10.1016/j. jsps.2013.09.001