Drug Use before and during Pregnancy in Japan: The Japan Environment and Children’s Study

Hidekazu Nishigori,Taku Obara,Satoshi Mizuno,Shinichi Kuriyama,Kunihiko Nakai,Mami Ishikuro,Toshie Nishigori,Ikuma Fujiwara,Nobuo Yaegashi,Takahiro Arima,Ichiko Nishijima,Nariyasu Mano,Nozomi Tatsuta,Kasumi Sakurai,Hirohito Metoki

doi:10.3390/pharmacy5020021

Abstract

Purpose: To elucidate drug use before and during pregnancy in Japan. Methods: The Japan Environment and Children’s Study (JECS) is an ongoing nationwide birth cohort study. We analyzed data from JECS involving cases where drugs were used for 12 months before pregnancy was diagnosed, between the time of diagnosis of pregnancy until week 12 of pregnancy, and after week 12 of pregnancy. Results: We analyzed data from 97,464 pregnant women. The percentages of pregnant women who had taken one or more drugs and supplements before diagnosis of pregnancy, between the time of diagnosis of pregnancy until week 12 of pregnancy, and after week 12 of pregnancy, were 78.4%, 57.1%, and 68.8% respectively. Excluding iron supplements, folic acid, and other vitamins and minerals, the percentages of women taking supplements were 75.3%, 36.0%, and 51.7% at each respective time point. The following drugs and supplements were frequently used for 12 months before pregnancy diagnosis: Commercially available antipyretics, analgesics, and/or medicine for treating common cold (34.7%), antipyretics, analgesics, and/or medicine for treating common colds, which were prescribed in hospitals (29.8%), antimicrobial drugs (14.0%), and anti-allergy drugs (12.5%). The following drugs and supplements were frequently used from the time of pregnancy diagnosis until week 12 of pregnancy, and after week 12 of pregnancy: folic acid (28.9% and 26.2%), antipyretics, analgesics and/or medicines for treating common cold, that were prescribed in hospitals (7.8% and 13.3%), Chinese herbal medicines (6.0% and 9.4%, and uterine relaxants (5.1% and 15.2%). Conclusions: The analysis of a nationwide cohort study showed that a high percentage of Japanese pregnant women were taking medicinal drugs. Further research is required to elucidate the relationship between drug use during pregnancy and birth defects in Japan.

Highlights

The eligibility criteria for participants were as follows: (1) They should reside in the study areas at the time of the recruitment, and would be expected to reside continually in Japan for the foreseeable future, (2) expected delivery date should be between 1 August 2011 and mid-2014, and (3) they should be capable to participate in the study without difficulty, i.e., they must be able to comprehend the Japanese language and complete the self-administered questionnaire
The following drugs and supplements were frequently used from the time of pregnancy diagnosis until week 12 of pregnancy: (1) folic acid (28.89%), (2) antipyretics, analgesics, and/or medicine for treating common cold prescribed in hospitals (7.76%), (3) Chinese herbal medicines (6.02%), (4) uterine relaxants (5.11%), and (5) minerals (4.92%)
The following drugs and supplements were frequently used from the time of diagnosis of pregnancy until week 12 of pregnancy: (1) folic acid (28.89%), (2) antipyretics, analgesics, and/or medicine for treating common cold prescribed in hospitals (7.76%), and (3) Chinese herbal medicines (6.02%)

Summary

Introduction

A number of drugs are known to exert latent harm on pregnant women and their fetuses [1].According to previous studies on drug use in pregnant women, 40%–90% of these women take at least one drug [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]. A number of drugs are known to exert latent harm on pregnant women and their fetuses [1]. A study found that the use of a single drug acting on the central nervous system was not related to congenital abnormalities; the use of multiple such drugs presented a higher risk of congenital abnormalities [25]. It is important for surveys to be conducted on multidrug use and drug use in pregnant women. In the Japanese health system, patients mainly obtain their prescribed drugs from community-based pharmacies, based on a prescription made by a doctor in a community clinic or hospital. Patients can buy over-the-counter drugs in most community pharmacies. To the best of our knowledge, there has been no study based on a large-scale birth cohort survey in Japan

Methods

Results

Conclusion