Research
Obstetrics
Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008

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Objective

The objective of the study was to provide information on overall medication use throughout pregnancy, with particular focus on the first trimester and specific prescription medications.

Study Design

The study design included the Slone Epidemiology Center Birth Defects Study, 1976-2008, and the National Birth Defects Prevention Study, 1997-2003, which together interviewed more than 30,000 women about their antenatal medication use.

Results

Over the last 3 decades, first-trimester use of prescription medication increased by more than 60%, and the use of 4 or more medications more than tripled. By 2008, approximately 50% of women reported taking at least 1 medication. Use of some specific medications markedly decreased or increased. Prescription medication use increased with maternal age and education, was highest for non-Hispanic whites, and varied by state.

Conclusion

These data reflect the widespread and growing use of medications by pregnant women and reinforce the need to study their respective fetal risks and safety.

Section snippets

Birth Defects Study

Since 1976, the Boston University Slone Epidemiology Center BDS has interviewed mothers of infants with any major structural birth defects recruited from birth and tertiary care hospitals in a number of regional study centers (Boston, MA; Philadelphia, PA; Toronto, Canada; the state of Iowa, and San Diego, CA) as well as through birth defects registries in Massachusetts and New York State.

Beginning in 1993, a sample of mothers of infants without birth defects has also been included from each

All medications (OTC and prescription medications combined)

For the 33 year BDS study, Figure 1 presents secular patterns of use of any medication at any time during pregnancy as well as any medication taken in the first trimester. Overall, the average number used any time in pregnancy increased by 68%, from 2.5 in 1976-1978 to 4.2 in 2006-2008 (range, 0–28); in the last year, 93.9% took at least 1 medication. During the first trimester, the average number of medications increased during those same years by 62.5%, from 1.6 to 2.6 (range, 0–25); 82.3% of

Comment

The US Collaborative Perinatal Project reported the use of specific prescription and OTC medications in more than 50,000 women drawn from 12 study centers.14 However, those data, collected between 1957 and 1963, have limited relevance to current patterns. Other data, from more recent decades, have been subject to important limitations. Two studies conducted in the 1980s were small and focused on geographically limited populations over periods of only 22 or 6 years.3 Much larger datasets, drawn

Acknowledgment

We wish to thank Dr Margaret Honein for her support and guidance.

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Cite this article as: Mitchell AA, Gilboa SM, Werler MM, et al. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol 2011;205:51.e1-8.

Reprints not available from the authors.

This study was supported in part by Cooperative Agreement no. U50/CCU113247 with the Centers for Disease Control and Prevention through the Massachusetts Department of Public Health, Cooperative agreements under program announcement no. 02081 from the Centers for Disease Control and Prevention to the centers participating in the National Birth Defects Prevention Study, and Grant R01 HD 046595 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The views expressed herein are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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