Drug use by pregnant women and comparable non-pregnant women in The Netherlands with reference to the Australian classification system.
OBJECTIVE
To describe drug use in pregnancy, and compare drug use of pregnant women with non-pregnant women with respect to possible teratogenicity.


METHODS
A cross-sectional study based on pharmacy records from 1997 to 2001 was performed. Pregnant women and matched non-pregnant women (same physician and age) were identified. Prescriptions were set against the Australian risk classification.


RESULTS
Thirty-five percent of all prescriptions for non-pregnant women were safe in pregnancy (Australian classification A), in 14% the risk was unknown (B1, B2), 49% were potentially harmful drugs (B3, C, D, X), and in 3% no classification was available. For pregnant women these figures were 86, 3, 10 and 2%, respectively. In non-pregnant women the highest percentages of prescriptions for unsafe drugs were for psycholeptics (99% not classified as safe), psychoanaleptics (100%), anti-inflammatory/antirheumetic products (100%), antihistamines (94%), antacids/anti-ulcer drugs (81%), antiepileptics (100%), beta-blockers (100%), systemic antimycotics (100%), antiprotozoals (97%), diuretics (100%) and immunosuppressives (100%). In pregnant women this pattern was comparable, except for antihistamines (22%) and antacids/anti-ulcer drugs (3%).


CONCLUSIONS
We conclude that many drugs used by non-pregnant women should be avoided in pregnancy, and that pregnant women indeed do so. However, for some drug groups the available safe alternatives are limited.
Schirm
Eric
E
Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, The Netherlands. e.shirm@farm.rug.nl
Meijer
Willemijn M
WM
Tobi
Hilde
H
de Jong-van den Berg
Lolkje T W
LT
D000014:Abnormalities, Drug-Induced; D001315:Australia; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D009426:Netherlands; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000145:classification*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012307:Risk Factors
D004364:Pharmaceutical Preparations