Investigating drug use in pregnancy. Methodological problems and perspectives

Area of Science:

• Obstetrics and Gynecology
• Clinical Pharmacy
• Pharmacoepidemiology

Background:

• Drug use during pregnancy is common and varies throughout gestation.
• Understanding prescribing patterns is crucial for maternal and fetal health.
• Previous research has not comprehensively detailed drug exposure across pregnancy stages.

Purpose of the Study:

• To describe the patterns of prescribed drug use before, during, and after pregnancy.
• To analyze changes in drug utilization across different trimesters and postpartum.
• To establish a baseline for future research on drug safety and efficacy in pregnancy.

Main Methods:

• Retrospective analysis of pharmacy records from 1,948 women delivering live-born infants.
• Evaluation of drug exposure using various quantitative measures.
• Categorization of drug use by trimester and postpartum period.

Main Results:

• 86% of women used an average of 4.2 prescriptions during pregnancy.
• Increased use of gastro-intestinal and blood-forming drugs; decreased use of cardiovascular, antiphlogistic, and CNS drugs.
• Specific drug classes showed distinct usage patterns: anti-emetics (1st trimester), antacids (3rd trimester), laxatives (postpartum), and iron supplements (low dosage).

Conclusions:

• The study reflects typical prescribing patterns for Dutch pregnant women.
• Findings provide a foundation for investigating drug exposure risks and use in pregnant women with comorbidities.
• Further research can inform recommendations to optimize prescribing behavior during pregnancy.