Drugs in Pregnancy

Do the Benefits Outweigh the Risks?

Anita T. Mosley, PhD, PharmD; Amy P. Witte, PharmD

Disclosures

US Pharmacist. 2013;38(9):43-46. 

In This Article

Abstract and Introduction

Abstract

More than 80% of pregnant women take OTC or prescription drugs during pregnancy, with only 60% of these patients consulting a health care professional when selecting a product. Common pregnancy-associated conditions include cough, cold, allergies, gastrointestinal disorders, and pain. The cough, cold, and allergy products most widely used during pregnancy are antihistamines, decongestants, antitussives, and expectorants. Current updates to the immunization schedule include administering tetanus, diphtheria, and acellular pertussis (Tdap) vaccine with each pregnancy. Influenza vaccination should also be recommended for all pregnant women and can be given in any trimester. The decision to treat pregnancy-associated conditions should be based on a number of factors, including safety, symptom severity, and potential for quality-of-life improvement.

Introduction

The prevalence of medication use during pregnancy is widespread and on the rise. More than 80% of pregnant women take OTC or prescription drugs during pregnancy, with only 60% of these patients consulting a health care professional when selecting a product.[1] There is a delicate risk-benefit estimation concerning the health of both the mother and the fetus that must be considered in the use of drugs during pregnancy.

During pregnancy, the timing of fetal exposure to a drug is critical to the likelihood of an adverse effect occurring.

A study investigating the use of prescription, OTC, and herbal medicines in a rural obstetric population of 578 participants found that over 90% of the patients took either prescription and/or OTC medication.[2] A larger cohort study (multicenter, urban) found that 64% of expectant mothers had been prescribed a drug other than a vitamin or mineral supplement at some point during their pregnancy.[3]

Medication use during pregnancy can generally be attributed to preexisting conditions such as hypertension or cardiac problems, pregnancy-associated conditions such as nausea and vomiting, or acute conditions such as seasonal allergies or bacterial infections. Among the most frequently used medications in pregnancy are antiemetics, antacids, antihistamines, analgesics, antimicrobials, diuretics, hypnotics, and tranquilizers.[4]

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