Clinical Microbiology and Antimicrobial Chemotherapy. 2007; 9(2):162-175
The use of any medications during pregnancy is associated with a potential risk for deleterious effect on fetus and neonate. Many women take drugs during pregnancy however no studies were conducted to examine the extent of drug prescription to pregnant women in Russia. A retrospective study was conducted in six Russian cities among women regularly attending prenatal clinic with a late pregnancy (>35 gestational weeks). All prescribed drugs, including vitamins and minerals with brand name, dosage, date, duration and indication were monitored throughout the whole pregnancy from the first antenatal visit to gynecologist. Information was collected from original medical records in maternal obstetric history (supplemented with prescriptions during hospital stays, if available). Drugs were coded using the ATC classification (WHO, version 2004). Among 543 women enrolled, 100% received a prescription for at least one drug during pregnancy with a mean of 11.0±5.3 (range, 1 to 26) medications per women. Without vitamins, minerals, iron and iodide the average number was 6.7±3.8 (range, 1 to 19) but only 8 (1.5%) women had no other drug prescriptions. High rates of drug prescription were noted in the first trimester – 72.0% of women were administered at least one drug with a mean number 3.2±1.9 (range, 1 to 16) medications a prescription. The most frequently prescribed preparations were multivitamins (92.4% of women), iron (80.9%), spasmolytics (70.7%), gynecological antiinfectives/antiseptics (50.3%), folic acid (48.8%), minerals (48.6%), herbal urologicals (47.7%), antithrombotics, mainly dipyridamole (46.2%), herbal sedatives (43.8%), bile and liver drugs (40.1%). Commonly prescribed were vasoprotectives, mainly ascorutin (35.7%), tocolytics (27.1%), «actovegin» (26.2%), systemic antibiotics (21.5%). In accordance with the US Food and Drug Administration (FDA) risk classification system in pregnancy, most of the women were administered drugs with potentially dangerous effect on a fetus, as well as drugs with understudied safety during pregnancy. Based on the results of our study drug use during pregnancy in Russia should be continuously monitored and strictly related to an evidence based guidelines on efficacy and safety.