Drugs exposures during pregnancy and neonatal risk assessment
Kamal A Ibrahim, Ehijie F O Enato, Dayom D Wetkos
Background: Medication use is inevitable in the management of chronic or acute disease conditions during pregnancy. However, obstetric pharmacotherapy is most challenging for healthcare providers as they make effort to balance the benefit and risk of medication use during pregnancy.Objective: To profile medical conditions and medication use during pregnancy, and to assess potential or actual neonatal risks following drug exposure in pregnancy.Methods: The study was carried out in 6 healthcare facilities in Edo State, Nigeria. A total of 2,530 pregnant women attending antenatal clinics (ANC) in the health facilities were recruited and followed-up to delivery. Demographic, clinical, obstetric, and drug information were collected from women during their first encounter with the investigator and these data were updated in subsequent follow-up visits by the women. Data were collected through interviews, review of medical records and ANC cards. At delivery, the clinical information of the neonates was obtained and recorded and neonatal risk assessment undertaken. The prescribed medications were classified as safe, low risk and high risk drugs in pregnancy. Paired sample t-test method was used to copmpared categorical veriables and p-values <0.05 were considered significant.Results: A total of 900 out of the 2,530 participants were followed up to delivery. Malaria and other infectious diseases were the most commonly encountered medical conditions, and 6,639 medication exposures during pregnancy were reported among the 2,530 participants. Most drugs were used during second and third trimesters of pregnancy. Apart from routine drugs (iron salts and multivitamins), anti-malarial drugs (55.4%, 889/1605), and antimicrobials (19.7%, 316/1605) were most commonly prescribed. Neonatal risk assessment indicated that 47.5%, 45.7% and 5% of the drug encountered were considered safe, low risk and high risk in pregnancy respectively. One congenital malformation (extra digit in the new born) was reported in the neonates.Conclusion: The study revealed that anti-malarial drugs and antimicrobials were most frequently prescribed. Almost all prescribed drugs were either safe or of low risk in pregnancy. It was observed that drugs use during first trimester of pregnancy was low.
Kamal A Ibrahim, Ehijie F O Enato, Dayom D Wetkos. Drugs exposures during pregnancy and neonatal risk assessment. International Journal of Pharmaceutical and Clinical Research, Volume 3, Issue 1, 2021, Pages 33-42