title: Drug exposure and pregnancy outcome in Mozambique.
abstract: BACKGROUND
  The intake of medicines during pregnancy can have negative or toxic effects on the fetus, possibly leading to adverse pregnancy outcomes.
  
  
  OBJECTIVE
  The aim of this study was to describe the level of drug exposure during pregnancy in a rural area of Mozambique and its relation to pregnancy outcome.
  
  
  METHODS
  A total of 3105 pregnant women were interviewed in a cohort study. Information on disease, treatments received during pregnancy, and pregnancy outcome was collected. Newborns were examined at birth for clinical signs, birthweight, and presence of any congenital malformation.
  
  
  RESULTS
  Malaria and sexually transmitted diseases were the most frequently reported diseases (30.5% and 24.1%, respectively), and 41% (1276/3105) of participants reported at least one drug exposure. The mean number of drugs taken per pregnant woman was 3.9 (SD 2.1). Antibiotics were the most commonly (41.2%) reported agents, followed by antimalarials (23.8%). There were more stillbirths (p < 0.007) among those reporting to be exposed to drugs compared with no exposure. Polydactyly was the most frequent malformation observed.
  
  
  CONCLUSIONS
  Drug exposure during pregnancy, including drugs with recognized potential pregnancy risk, was high in this rural area of southern Africa. The association of stillbirths with drug exposure might be a consequence of the disease that led to drug administration, although a direct causality of the drugs cannot be excluded. These findings emphasize the need for reinforcing pharmacovigilance systems in rural Africa, especially, or at least, in pregnant women.
authors.affiliation: Universidade Eduardo Mondlane, Faculdade de Medicina, CIMed, Maputo, Mozambique. esevene68@gmail.com
authors.forename: Esperança
authors.initials: E
authors.lastname: Sevene
authors.forename: Azucena
authors.initials: A
authors.lastname: Bardají
authors.forename: Alda
authors.initials: A
authors.lastname: Mariano
authors.forename: Sónia
authors.initials: S
authors.lastname: Machevo
authors.forename: Edgar
authors.initials: E
authors.lastname: Ayala
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigaúque
authors.forename: John J
authors.initials: JJ
authors.lastname: Aponte
authors.forename: Xavier
authors.initials: X
authors.lastname: Carné
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menendez
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000962:Antimalarials / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology; D009073:Mozambique / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology*; D012424:Rural Population; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials