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

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


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.


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.


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

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  1. Koren G, Pastuszak A, Shinya I (1998) Drugs in pregnancy. N Engl J Med 338:1128–1137

    Article  CAS  PubMed  Google Scholar 

  2. Rubin P (1998) Drug treatment during pregnancy. BMJ 317:1503–1506

    CAS  PubMed  Google Scholar 

  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 13:181–197

    Google Scholar 

  4. Aviv RI, Chubb K, Londow SW (1993) The prevalence of maternal medication ingestion in the antenatal period. S Afr Med J 83:657–660

    CAS  PubMed  Google Scholar 

  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 38:325–328

    Google Scholar 

  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 39:185–196

    PubMed  Google Scholar 

  7. Costa da Fonseca MRC, da Fonseca E, Bergsten-Mendes G (2002) Prevalence of drug use during pregnancy: a pharmacoepidemiological approach. Rev Saude Publica 36:205–212

    PubMed  Google Scholar 

  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 52:977–982

    Google Scholar 

  9. Donati S, Baglio G, Spinelli A, Grandolfo ME (2000) Drug use in pregnancy among Italian women. Eur J Clin Pharmacol 56:323–328

    Article  Google Scholar 

  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 188:1039–1045

    Article  PubMed  Google Scholar 

  11. Henry A, Crowther C (2000) Patterns of medication use during and prior to pregnancy: the MAP study. Aust N Z J Obstet Gynaecol 40:154–172

    Google Scholar 

  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 35:572–576

    CAS  PubMed  Google Scholar 

  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 54:645–651

    Article  PubMed  Google Scholar 

  14. Lacroix I, Damase-Michel C, Lapeyre-Mestre M, Montastruc JL (2000) Prescription of drugs during pregnancy in France. Lancet 356:1735–1736

    Article  CAS  PubMed  Google Scholar 

  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 55:139–144

    Google Scholar 

  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 46:581–589

    Google Scholar 

  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 15:74–87

    Article  CAS  PubMed  Google Scholar 

  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 12:497–501

    CAS  PubMed  Google Scholar 

  19. Harlow SD, Linnet MS (1989) Agreement between questionnaire data and medical records. The evidence for accuracy of recall. Am J Epidemiol 129:233–248

    CAS  PubMed  Google Scholar 

  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 12:461–466

    Article  CAS  PubMed  Google Scholar 

  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 45:9–14

    PubMed  Google Scholar 

  22. Mitchell AA, Cottler LB, Shapiro S (1986) Effect of questionnaire design on recall of drug exposure in pregnancy. Am J Epidemiol 123:670–676

    CAS  PubMed  Google Scholar 

  23. Rubin PC, Craig GF, Gavin K, Sumner D (1986) Prospective survey of use of therapeutic drugs, alcohol, and cigarettes during pegnancy. BMJ 292:81–83

    CAS  PubMed  Google Scholar 

  24. Forfar JO, Nelson MM (1973) Epidemiology of drugs taken by pregnant women: drugs that may affect the fetus adversely. Clin Pharmacol Ther 14:632–642

    CAS  PubMed  Google Scholar 

  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 57:958–963

    Article  CAS  PubMed  Google Scholar 

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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.

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Headley, J., Northstone, K., Simmons, H. et al. Medication use during pregnancy: data from the Avon Longitudinal Study of Parents and Children. Eur J Clin Pharmacol 60, 355–361 (2004).

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