Prescription Medication Use During Pregnancy and Postpartum in Sweden 2007 to 2022

Medication use during pregnancy has increased worldwide. The aim was to investigate patterns of prescription medication use during pregnancy and postpartum in Sweden 2007-2022.

We conducted a population-based drug utilization study with linked data from the Swedish Medical Birth and Prescribed Drug Registers. From 90 days before pregnancy to 90 days after delivery, all dispensed prescriptions for each full-level ATC code were identified. The proportion of women, by year and age, with ≥ 1 dispensed medication was calculated, as well as the number of different medications and dispensed prescriptions of structural teratogens and specific medication groups.

Overall, 1 065 593 (60.5%) women were dispensed ≥ 1 medication during pregnancy and 900 536 (51.1%) within 3 months postpartum. The proportion of women with ≥ 1 dispensed prescription in the postpartum period was stable but increased during pregnancy from 57.1% in 2007 to 67.5% in 2022, with the largest increase in women ≥ 40 years. The proportion using ≥ 5 different medications increased, while the proportion with a recognized or suspected structural teratogen in the first trimester remained low (< 1%). There was a notable decrease in the use of antibiotics and prescribed analgesics, and an increase in antiemetics, psychotropics, acetylsalicylic acid, anticoagulants, antihypertensives, and antidiabetics.

Medication use during pregnancy in Sweden increased from 2007 to 2022, particularly among women ≥ 40 years, while postpartum use remained stable. Shifts in the use of specific medication groups highlight evolving maternal characteristics and clinical practice, as well as the importance of continuous surveillance and investigation of medication safety.