A drug utilization study in pregnancy at a tertiary care teaching hospital

Abstract

Background: Pregnancy is a state of altered physiological condition where drug treatment poses concern as it can put the fetus at a potential risk. It is associated with pharmacokinetic and pharmacodynamic alterations. Transportation across the placenta can cause teratogenic effects. Thus, the risk/benefit ratio of drug therapy should be carefully evaluated in pregnancy. Aim and Objective: The aim of the study was to evaluate the pattern of drug use in pregnancy. Materials and Methods: A prospective cross-sectional study was carried out at the ante-natal clinic of a tertiary care teaching hospital in Ahmedabad. Prescriptions of 500 pregnant women were screened. The necessary demographic details, educational status, antenatal history, use of any medicines, or home remedies were noted. The data collected were analyzed for various use patterns on a MS-Excel sheet. Results: Majority of the prescriptions were issued to the women in 21–35 years (89.4%) age group and 56.8% were multigravida. Majority of women (61%) were in 3rd trimester followed by the 2nd trimester (28.8%). Out of 500 women, only 73 (14.6%) had complaints such as vomiting, hyperacidity, cold, cough, burning micturition, vaginal itching, and discharge. Total number of drugs used was 1299 of which 62.58% were used in 3rd trimester, 29.79% in 2nd trimester, and 7.62% in the 1st trimester. The average number of drugs per prescription was 2.59. Out of all drugs used, 1108 (85%) were given as fixed dose combinations. Injectables were 18 in number (1.5%). Common drugs used were vitamins and supplements (81.13%), anti-emetics (3.84%), antacids (3.54%), thyroid analogues (2.3%), and anti-hypertensives (1.46%). A home remedy was used by 11.8% and an ayurvedic medication was used by 1.4% women. According to US-Food and Drug Administration pregnancy risk categories, 15% drugs were in category A, 47% in category B, 38% in category C, 0.84% in category D, and none in category X. Self-medication was seen in 20 (4%) women and was common among literate women. Conclusion: The present study shows that the drugs are consumed during pregnancy usually for a necessary indication. Vitamins and other supplements are the most commonly prescribed medication while other drugs are used only when needed. No category X drugs were prescribed or taken as self-medication.