Obtaining drug exposure histories during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Clinical Pharmacy
• Pharmacovigilance

Background:

• Accurate documentation of drug exposure during pregnancy is crucial for maternal and fetal health.
• Existing methods for assessing medication use in pregnant patients are often inadequate.
• Physicians may be unaware of the full spectrum of pharmacologic agents used by their patients.

Purpose of the Study:

• To verify the amount of drugs ingested by pregnant patients during their pregnancies.
• To assess the accuracy of standard drug history documentation methods in pregnant patients.
• To determine the extent of underestimation of fetal drug exposure by conventional methods.

Main Methods:

• Inclusion of 153 pregnant patients in the study.
• Utilizing hospital pharmacist drug history interviews and patient home diaries for data collection.
• Assessing patient compliance with home diary use for recording drug and chemical intake.

Main Results:

• A significant number of pharmacologic agents were used by pregnant patients, often unknown to their physicians.
• Patient compliance with home diary use was high at 83% (127 patients).
• Standard drug history documentation methods identified only 30% of actual fetal drug exposure.

Conclusions:

• The patient's medical record is grossly inadequate for documenting accurate drug exposure during pregnancy.
• Home diaries and pharmacist interviews offer improved, though not complete, insights into medication use.
• There is a critical need for improved methods to accurately assess and document drug exposure in pregnant patients to ensure fetal safety.