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Medication Use During Pregnancy Is Increasing


An increasing number of women are using medications during pregnancy, according to a new study recently released online in the American Journal of Obstetrics and Gynecology. The rise in medication use among pregnant women potentially places their children in harm’s way.

The effects of most drugs are not known

A few drugs, such as isotretinoin, thalidomide, Phenobarbital, and valproate, have been identified as causing birth defects. However, despite the vast amount of drug research that has been done, little is known about the effects of the majority of prescription and over-the-counter drugs on the fetus.

Therefore, it is possible for pregnant women to unknowingly take medications that could harm their child. At the same time, the lack of solid information about which drugs could cause birth defects can prompt some pregnant women to stop taking medications they need to treat serious medical conditions.

The new study was the result of a collaboration between researchers from Boston University’s Slone Epidemiology Center, Harvard School of Public Health, and the Centers for Disease Control and Prevention. The investigators evaluated data collected from interviews conducted from 1976 to 2008 with more than 30,000 women who reported on their use of prescription and OTC medications during pregnancy.

Overall, the investigators found that 70 to 80 percent of women said they had taken at least one medication during their first trimester, and that about half of women reported taking at least one prescription medication during those first few months of pregnancy. The first trimester is considered to be when the risk of birth defects is greatest.

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Investigators also discovered that use of prescription drugs during the first trimester over the last three decades has increased by more than 60 percent, and that women who use 4 or more medications during those early months has tripled. Antidepressant use during the first trimester has increased dramatically.

Other findings of the study included an increase in medication use as women grew older and had more education, and greater use among non-Hispanic white women compared with women of other ethnicities or races.

Although research into the risks and safety of medication use during pregnancy is incomplete, there are guidelines physicians and women can follow. Daniel Roshan, MD, assistant professor of ob-gyn at New York University School of Medicine has noted that all medications can be categorized as safe or unsafe for use during pregnancy, according to a listing of A, B, C, D, or X.

“The only ‘A’ drugs are prenatal vitamins and thyroid medication,” according to Roshan in an article in Parents. Drugs in the ‘B’ category are considered safe in animals studies but have no human studies; ‘C’ drugs cause adverse effects in animals but there are no human studies; ‘D’ drugs can cause birth defects; and ‘X’ drugs should never be used.

According to Allen A. Mitchell, MD, director of Boston University’s Slone Epidemiology Center, their findings “reinforce the need for ongoing surveillance regarding medication use in pregnancy and its consequences.” He pointed out that it is necessary to know how many medications pregnant women are taking, what those medications are, and how their use of medications changes over time to best protect the fetus and the mother.

Mitchell AA et al. American Journal of Obstetrics and Gynecology 2011; online; doi: 10.1016/j.ajog.2011.02.029
Rx and Pregnancy: What Medications are Safe? Parents