title: Multiple information sources and consequences of conflicting information about medicine use during pregnancy: a multinational Internet-based survey.
abstract: BACKGROUND
  A wide variety of information sources on medicines is available for pregnant women. When using multiple information sources, there is the risk that information will vary or even conflict.
  
  
  OBJECTIVE
  The objective of this multinational study was to analyze the extent to which pregnant women use multiple information sources and the consequences of conflicting information, and to investigate which maternal sociodemographic, lifestyle, and medical factors were associated with these objectives.
  
  
  METHODS
  An anonymous Internet-based questionnaire was made accessible during a period of 2 months, on 1 to 4 Internet websites used by pregnant women in 5 regions (Eastern Europe, Western Europe, Northern Europe, Americas, Australia). A total of 7092 responses were obtained (n=5090 pregnant women; n=2002 women with a child younger than 25 weeks). Descriptive statistics and logistic regression analysis were used.
  
  
  RESULTS
  Of the respondents who stated that they needed information, 16.16% (655/4054) used one information source and 83.69% (3393/4054) used multiple information sources. Of respondents who used more than one information source, 22.62% (759/3355) stated that the information was conflicted. According to multivariate logistic regression analysis, factors significantly associated with experiencing conflict in medicine information included being a mother (OR 1.32, 95% CI 1.11-1.58), having university (OR 1.33, 95% CI 1.09-1.63) or other education (OR 1.49, 95% CI 1.09-2.03), residing in Eastern Europe (OR 1.52, 95% CI 1.22-1.89) or Australia (OR 2.28, 95% CI 1.42-3.67), use of 3 (OR 1.29, 95% CI 1.04-1.60) or >4 information sources (OR 1.82, 95% CI 1.49-2.23), and having ≥2 chronic diseases (OR 1.49, 95% CI 1.18-1.89). Because of conflicting information, 43.61% (331/759) decided not to use medication during pregnancy, 30.30% (230/759) sought a new information source, 32.67% (248/759) chose to rely on one source and ignore the conflicting one, 25.03% (190/759) became anxious, and 2.64% (20/759) did nothing. Factors significantly associated with not using medication as a consequence of conflicting information were being pregnant (OR 1.75, 95% CI 1.28-2.41) or experiencing 3-4 health disorders (OR 1.99, 95% CI 1.10-3.58). Women with no chronic diseases were more likely not to take medicines than women with ≥2 chronic diseases (OR 2.22, 95% CI 1.47-3.45). Factors significantly associated with becoming anxious were >4 information sources (OR 2.67, 95% CI 1.70-4.18) and residing in Eastern Europe (OR 0.57, 95% CI 0.36-0.90).
  
  
  CONCLUSIONS
  Almost all the pregnant women used multiple information sources when seeking information on taking medicines during pregnancy and one-fifth obtained conflicting information, leading to anxiety and the decision not to use the medication. Regional, educational, and chronic disease characteristics were associated with experiencing conflicting information and influenced the decision not to use medication or increased anxiety. Accurate and uniform teratology information should be made more available to the public.
authors.affiliation: Assessment of Pharmacotherapies, Finnish Medicines Agency, Fimea, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Hämeen-Anttila
authors.forename: Hedvig
authors.initials: H
authors.lastname: Nordeng
authors.forename: Esa
authors.initials: E
authors.lastname: Kokki
authors.forename: Johanna
authors.initials: J
authors.lastname: Jyrkkä
authors.forename: Angela
authors.initials: A
authors.lastname: Lupattelli
authors.forename: Kirsti
authors.initials: K
authors.lastname: Vainio
authors.forename: Hannes
authors.initials: H
authors.lastname: Enlund
mesh_terms: D000569:Americas; D001315:Australia; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D003625:Data Collection; D004358:Drug Therapy; D005060:Europe; D005190:Family; D005260:Female; D033062:Friends; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D057226:Information Seeking Behavior; D007255:Information Services / Q000706:statistics & numerical data; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Internet; access to information; information dissemination; information seeking behavior; international; pharmaceutical preparations; pregnancy; questionnaires