Abstract
BackgroundDrug consumption during pregnancy is a matter of concern, especially regarding drugs known or suspected to be teratogens. Little is known about drug use in pregnant women in Italy. The present study is aimed at examining the prevalence, and to detect potential inappropriateness of drug prescribing among pregnant women in Latium, a region of central Italy.MethodsThis retrospective study was conducted on a cohort of women aged 18-45 years who delivered between 2008 and 2012 in public hospitals. Women were enrolled through the Regional Birth Register. After linking the regional Health Information Systems and the Regional Drug Claims Register, women’s clinical data and prescribed medications were analyzed. Italian Medicine Agency (AIFA) and US Food and Drug Administration (FDA) evidence were used to investigate inappropriate prescribing and teratogenic risk.ResultsExcluding vitamins and minerals, 80.6% (n = 153,079) of the women were prescribed at least one drug during pregnancy, with an average of 4.6 medications per pregnancy. Drugs for blood and hematopoietic organs were the most commonly prescribed (53.0%,), followed by anti-infectives for systemic use (50.7%). Among the inappropriate prescriptions, progestogen supplementation was given in 20.1% of pregnancies; teratogen drugs were prescribed in 0.8%, mostly angiotensin co-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) (0.3%).ConclusionsIn Latium, drugs are widely used in pregnancy. Prescriptions of inappropriate drugs are observed in more than a fifth of pregnancies, and teratogens are still used, despite their known risk. Continuous updates of information provided to practitioners and an increased availability of information to women might reduce inappropriate prescribing.
Highlights
Drug consumption during pregnancy is a matter of concern, especially regarding drugs known or suspected to be teratogens
During the five-year study period we identified 189,923 deliveries, 61.2% of women were primiparous and 92.7% of pregnancies ended at term
The most frequently prescribed agents were drugs for blood and hematopoietic organs (53.0%, n = 100,663), with folic acid prescribed in 37% and iron in 26.3% of women, followed by antiinfectives for systemic use (50.7%, n = 96,251)
Summary
Drug consumption during pregnancy is a matter of concern, especially regarding drugs known or suspected to be teratogens. A cross-sectional, multinational web-based study on the drug consumption in pregnant women showed that approximately 8 out of 10 women reported the use of at least one medication, either prescribed or over the counter, during the course of their pregnancy [11]. A limited number of studies has examined the use of prescription drugs among pregnant women in Italy [12,13,14,15]. The objective of this population-based study is the analysis of drug prescribing among pregnant women in Latium with specific regard to inappropriate and potentially or known teratogenic drugs
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