Dr Sara A. Hanafy

Pharmacist, Public Health Specialist, PhD candidate, Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt.

Dr Sara would like to share her study that was done for the fulfillment of her Master degree in Public Health (MPH) at the High Institute of Public Health, Alexandria University.

Drug use (DU) in pregnancy is a global public health concern in both developed and developing countries. Concern about the safety of drugs prescribed to pregnant women has been increasingly evident since the thalidomide tragedy in the 1960s. Pregnant women consume drugs including prescription and non-prescription (OTC) medications as well as herbal products and dietary supplements. A cross-sectional study was carried out among 600 pregnant women in Alexandria, Egypt, in the duration 2012 – 2015 to assess the magnitude and pattern of DU during pregnancy. Medications taken by pregnant women were evaluated based on the pregnancy risk classification system of the Food and Drug Administration (FDA). The FDA risk classification (A, B, C, D, or X) was assigned to individual medications. Category A (adequate and well-controlled human studies have failed to demonstrate a risk to the fetus), category B (animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate controlled studies in humans), category C (animal reproduction studies have shown an adverse effect on the fetus and there are no adequate controlled studies in humans), category D (positive evidence of human fetal risk is confirmed), and category X (studies in animals or humans have demonstrated fetal abnormalities). The main findings revealed a high prevalence (96.3%) of DU during pregnancy. The proportion of prescribed-only- medications (POM) was 95.6%, compared to only 4.4% over-the-counter (OTC) medications. Category B medications (41.3%), 30.2% unclassified, 15.0% category C, 12.1% category A, 0.9% category X and 0.5% category D. Most commonly used medications were for GIT disorders (25.3%). The majority of respondents (88.0%) took supplements and a relatively high prevalence (41.8%) of herbal intake was observed with 56.3% of herbs consumed in the first trimester. In conclusion, the study highlighted an irrational prescribing trend of drugs during pregnancy. The prevalence of teratogenic medications of category D and X is of concern even if it is low. High herbal use especially in first trimester warrants special attention.

The study was published in the European Journal of Pharmaceutical and Medical Research. http://ejpmr.com/admin/assets/article_issue/1471588142.pdf

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