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European Journal of Clinical Pharmacology

, Volume 60, Issue 5, pp 355–361 | Cite as

Medication use during pregnancy: data from the Avon Longitudinal Study of Parents and Children

  • J. HeadleyEmail author
  • K. Northstone
  • H. Simmons
  • J. Golding
  • and the ALSPAC Study Team
Pharmacoepidemiology and Prescription

Abstract

Objective

To present data on the self-reported use of all types of medicinal products collected during pregnancy in a large cohort in southwest England.

Methods

Pregnant women with a delivery date during 1991-1992 and forming part of the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC) were sent up to four self-completion postal questionnaires during pregnancy. Text data collected from the questions on drug usage were coded using an ALSPAC drug dictionary based on the World Health Organization Drug Dictionary.

Results

At least one antenatal self-completion questionnaire was completed for 14,119 pregnancies, and 11,545 women completed all four. The data included prescription, over-the-counter, herbal and homeopathic products as well as iron, vitamins and other supplements. Only 7.6% did not report use of any medicinal product throughout their entire pregnancy. The remaining 92.4% used at least one product at some stage. After exclusion of iron, folate, vitamins, supplements, herbal and homeopathic products and skin emollients, 83% of those completing all questionnaires had used conventional therapeutic drugs. Analgesics were reported by approximately one-third of women at each stage during pregnancy, and paracetamol was the most frequently reported substance. Iron preparations were reported by 33% of the full cohort, at some stage, and folate by 21.9%. Use of anti-anaemic products increased during pregnancy with the greatest incidence at 32 weeks. Other vitamins and supplements were taken by 17.4% at some stage. Use of vitamins decreased throughout pregnancy from 9.6% in early pregnancy to 5% at 32 weeks. Antacids were reported by 23% at 32 weeks. The reported incidence of antibiotic use decreased slightly during pregnancy from 8% early on to 5.8% at 32 weeks; amoxicillin was the most frequently reported antibacterial.

Conclusion

Use of medicinal products was high during pregnancy in the ALSPAC cohort. This finding is consistent with data from recent publications.

Keywords

Pregnancy Drug use Medication 

Notes

Acknowledgements

We are extremely grateful to all the mothers who took part and to the midwives for their co-operation and help in recruitment. The whole ALSPAC study team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers and managers who continue to make the study possible. This study could not have been undertaken without the financial support of various organisations including the Wellcome Trust, the Medical Research Council, the University of Bristol, the Department of Health and the Department of the Environment. The ALSPAC study is part of the WHO-initiated European Longitudinal Study of Pregnancy and Childhood. The study complies with current British law including ethics approval.

References

  1. 1.
    Koren G, Pastuszak A, Shinya I (1998) Drugs in pregnancy. N Engl J Med 338:1128–1137CrossRefPubMedGoogle Scholar
  2. 2.
    Rubin P (1998) Drug treatment during pregnancy. BMJ 317:1503–1506PubMedGoogle Scholar
  3. 3.
    Sørensen HT, Nielsen GL, Andersen A-MN, Zhou WJ, Steffensen FH, Olesen C, Olsen J (1996) Drug use in pregnancy. Principal problems and a review of newer utilization studies. Clin Res Reg Affairs 13:181–197Google Scholar
  4. 4.
    Aviv RI, Chubb K, Londow SW (1993) The prevalence of maternal medication ingestion in the antenatal period. S Afr Med J 83:657–660PubMedGoogle Scholar
  5. 5.
    Bonati M, Bortolus R, Marchetti F, Romero M, Tognoni G (1990) Drug use in pregnancy: an overview of epidemiological (drug utilization) studies. Eur J Clin Pharmacol 38:325–328Google Scholar
  6. 6.
    Collaborative group on drug use in pregnancy (C.G.D.U.P.) (1992) Medication during pregnancy: an intercontinental cooperative study. Int J Gynaecol Obstet 39:185–196PubMedGoogle Scholar
  7. 7.
    Costa da Fonseca MRC, da Fonseca E, Bergsten-Mendes G (2002) Prevalence of drug use during pregnancy: a pharmacoepidemiological approach. Rev Saude Publica 36:205–212PubMedGoogle Scholar
  8. 8.
    De Vigan C, De Walle HEK, Cordier S, Goujard J, Knill-Jones R, Aymé S, Calzolari E, Bianchi F, and the OECM Working Group (1999) Therapeutic drug use during pregnancy. A comparison in four European countries. J Clin Epidemiol 52:977–982Google Scholar
  9. 9.
    Donati S, Baglio G, Spinelli A, Grandolfo ME (2000) Drug use in pregnancy among Italian women. Eur J Clin Pharmacol 56:323–328CrossRefGoogle Scholar
  10. 10.
    Glover DD, Amonkur M, Rybeck BF, Tracy TS (2003) Prescription, over-the-counter, and herbal medicine use in a rural, obstetric population. Am J Obstet Gynecol 188:1039–1045CrossRefPubMedGoogle Scholar
  11. 11.
    Henry A, Crowther C (2000) Patterns of medication use during and prior to pregnancy: the MAP study. Aust N Z J Obstet Gynaecol 40:154–172Google Scholar
  12. 12.
    Irl C, Hasford J, PEGASUS Study Group (1997) The PEGASUS project—a prospective cohort study for the investigation of drug use in pregnancy. Int J Clin Pharmacol Ther 35:572–576PubMedGoogle Scholar
  13. 13.
    Jiménez E, Bosch F, López A, Costa J, Cos R, Baños JE (1998) Patterns of regular drug use in Spanish childbearing women: changes elicited by pregnancy. Eur J Clin Pharmacol 54:645–651CrossRefPubMedGoogle Scholar
  14. 14.
    Lacroix I, Damase-Michel C, Lapeyre-Mestre M, Montastruc JL (2000) Prescription of drugs during pregnancy in France. Lancet 356:1735–1736CrossRefPubMedGoogle Scholar
  15. 15.
    Oleson C, Steffensen FH, Nielson GL, de Jong-van den Berg L, Olsen J, Sørensen HT, The EuroMAP Group (1999) Drug use in first pregnancy and lactation: a population-based survey among Danish women. Eur J Clin Pharmacol 55:139–144Google Scholar
  16. 16.
    Rubin JD, Ferencz C, Loffredo C (1993) Use of prescription and non-prescription drugs in pregnancy. The Baltimore-Washington infant study group. J Clin Epidemiol 46:581–589Google Scholar
  17. 17.
    Golding J, Pembrey M, Jones R, and the ALSPAC Study Team (2001) ALSPAC—The Avon longitudinal study of parents and children I. Study methodology. Paediatr Perinat Epidemiol 15:74–87CrossRefPubMedGoogle Scholar
  18. 18.
    Oleson C, Søndergaard C, Thrane N, Lauge Nielson G, de Jong-van den Berg L, Olsen J, for the EuroMAP Group (2001) Do pregnant women report use of dispensed medications? Epidemiology 12:497–501PubMedGoogle Scholar
  19. 19.
    Harlow SD, Linnet MS (1989) Agreement between questionnaire data and medical records. The evidence for accuracy of recall. Am J Epidemiol 129:233–248PubMedGoogle Scholar
  20. 20.
    Rockenbauer M, Olsen J, Czeizel AE, Pedersen L, Sørensen HT, and the EuroMAP Group (2001) Recall bias in a case-control surveillance system on the use of medicine during pregnancy. Epidemiology 12:461–466CrossRefPubMedGoogle Scholar
  21. 21.
    De Jong-van den Berg, LT, Waardenburg CM, Haaijer-Ruskamp FM, Dukes MN, Wesseling H (1993) Drug use in pregnancy: a comparative appraisal of data collecting methods. Eur J Clin Pharmacol 45:9–14PubMedGoogle Scholar
  22. 22.
    Mitchell AA, Cottler LB, Shapiro S (1986) Effect of questionnaire design on recall of drug exposure in pregnancy. Am J Epidemiol 123:670–676PubMedGoogle Scholar
  23. 23.
    Rubin PC, Craig GF, Gavin K, Sumner D (1986) Prospective survey of use of therapeutic drugs, alcohol, and cigarettes during pegnancy. BMJ 292:81–83PubMedGoogle Scholar
  24. 24.
    Forfar JO, Nelson MM (1973) Epidemiology of drugs taken by pregnant women: drugs that may affect the fetus adversely. Clin Pharmacol Ther 14:632–642PubMedGoogle Scholar
  25. 25.
    Shaheen SO, Newson RB, Sherriff A, Henderson, AJ, Heron JE, Burney PGJ, Golding J (2002) Paracetamol use in pregnancy and wheezing in early childhood. Thorax 57:958–963CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • J. Headley
    • 1
    Email author
  • K. Northstone
    • 1
  • H. Simmons
    • 1
  • J. Golding
    • 1
  • and the ALSPAC Study Team
    • 1
  1. 1.Unit of Paediatric and Perinatal EpidemiologyInstitute of Child Health, University of BristolBristol UK

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