title: Drug use during early pregnancy: cross-sectional analysis from the Childbirth and Health Study in Primary Care in Iceland.
abstract: OBJECTIVE
  To analyse drug use in early pregnancy with special focus on socio-demographic factors associated with psychotropic and analgesic drug use.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 1765 women were invited via their local health care centres, and 1111 participated at 11-16 weeks of pregnancy by filling out a postal questionnaire concerning socio-demographic and obstetric background, stressful life events, and drug use.
  
  
  METHODS
  Drug use prior to and early on in pregnancy, socio-demographic factors, smoking, and adverse life events were investigated. Drug categories screened for were psychotropics (collective term for antidepressants, relaxants, and sleep medication), analgesics, hormones, nicotine, vitamins/minerals, and homeopathic medicine.
  
  
  RESULTS
  Drug use from the aforementioned drug categories, excluding vitamins/minerals and homeopathic medicine, was reduced by 18% during early pregnancy, compared with six months prior to conception (49% vs. 60%). Psychotropic drug use during early pregnancy was associated with elementary maternal education (p < 0.5), being unemployed (p < 0.001), being single/divorced/separated (p < 0.01), smoking prior to or during pregnancy (p < 0.01), forced to change job/move house (p < 0.001), and psychotropic drug use six months prior to pregnancy (p < 0.001). No items on the stressful life events scale were associated with increased analgesic use, which increased only with multiparity.
  
  
  CONCLUSIONS
  Use of analgesics and psychotropic drugs seems common in pregnancy. Our results indicate that lack of a support network, stressful life events, and lower status in society may predispose women to more drug use. GPs and midwives responsible for maternity care could take this into account when evaluating risk and gain for women and foetuses in the primary care setting.
authors.affiliation: Department of Family Medicine, University of Iceland, Solvangur Health Centre , Hafnarfjordur , Iceland.
authors.forename: Thury O
authors.initials: TO
authors.lastname: Axelsdottir
authors.forename: Emil L
authors.initials: EL
authors.lastname: Sigurdsson
authors.forename: Anna M
authors.initials: AM
authors.lastname: Gudmundsdottir
authors.forename: Hildur
authors.initials: H
authors.lastname: Kristjansdottir
authors.forename: Johann A
authors.initials: JA
authors.lastname: Sigurdsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007055:Iceland; D011247:Pregnancy; D011248:Pregnancy Complications; D011320:Primary Health Care; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012907:Smoking; D012923:Social Class; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000700:Analgesics; D011619:Psychotropic Drugs
keywords: Childbirth and health; Iceland; drug use; general practice; maternity care; pregnancy; primary health care; psychotropic drugs