Abstract
Nation-wide information about medication use in pregnancy is lacking for Italy, and no study has so far investigated the prescribed medications which pregnant women deliberately avoid. In this study, we map medication use patterns in pregnancy, as well as the extent and type of prescribed medications which are purposely avoided by pregnant women in Italy. This is a sub-study within the “Multinational Medication Use in Pregnancy Study”—a cross-sectional, web-based study conducted in Italy from 7 November 2011 to 7 January 2012. Using an anonymous electronic questionnaire, we collected data from pregnant women and new mothers on medication use and deliberate avoidance during pregnancy and maternal characteristics. The sample included 926 women residing in Italy. The point prevalence of total medication use was 71.2%. Whereas 61.4% and 12.4% of women reported medication use for the treatment of short and longer-term illnesses, respectively, only 8.8% reported medication use for the treatment of both a short and a longer-term illness in pregnancy. We found no substantial differences in estimates across various geographical areas of Italy. Overall, 26.6% of women reported to have deliberately avoided a prescribed medication in pregnancy—most often nimesulide or ketoprofen, but also antibiotics. We conclude that prenatal exposure to medication is common among women in Italy, but estimates are lower than in other Western countries. Intentional avoidance of important medications by pregnant women raises concerns about the safeguarding of maternal–child health.
Highlights
Medication use in pregnancy has become an important public health concern in the last decades.Delayed childbearing—on the rise in most developed countries—and pregnant women’s preexisting disorders are among the factors posing greater risks of obstetrical complications [1,2]
The aim of this study was two-fold: (i) to examine the extent of and types of medications used during pregnancy in Italy, overall and for the treatment of short and longer-term illnesses; (ii) to map which prescribed medications are intentionally avoided by women during pregnancy and maternal factors associated with avoidance
The study is novel in providing insights into prescribed medications that are intentionally avoided during gestation and maternal factors related to this medication-taking behavior
Summary
Delayed childbearing—on the rise in most developed countries—and pregnant women’s preexisting disorders are among the factors posing greater risks of obstetrical complications [1,2]. Numerous acute or short-term illnesses—e.g., urinary tract infection (UTI) or nausea and vomiting—may negatively affect maternal–fetal health and well-being if sub-optimally treated [3,4]. For most of these disorders, whether short or longer-term, pharmacotherapy during pregnancy is often necessary. Due to obvious ethical reasons, safety studies on medication in pregnancy cannot be conducted during embryogenesis in humans. Most medications are put on the market without establishing their safety profile in human pregnancy.
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