2010 research findings
Pregnant women overestimate the risk of using medicines in pregnancy
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Pregnant women and mothers of infants overestimate the risk of birth defects following exposure to specific medicines, foods and chemicals. This also applies to the use of safe medicines like penicillin. These findings come from a collaborative study by the Norwegian Institute of Public Health, the University of Oslo and Toronto Hospital, Canada.
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In the study almost eight out of ten said they had sought information about medicines in pregnancy. The most common information sources were doctors, package inserts, pharmacists and the internet. Many women used multiple sources and in 25 percent of cases the information was inconsistent.
The most common consequence of inconsistent information was that the woman chose not to use the medicine. The researchers want to investigate to what extent attitudes affect the use of prescribed medicines.
“The study shows that pregnant women and mothers have many questions about safety, not only of medicines but also for other substances such as hair products, household chemicals and different foods," says researcher Hedvig Nordeng at the Division of Mental Health at the NIPH.
Nordeng is the first author on two recent articles published about the study (see links at bottom of page), which is the first of its kind in Norway.
Need for information
Most pregnant women in the study had a positive attitude towards medicines in general, but were unsure and reluctant to use medicines in pregnancy.
”The need for information is huge. It is wise to have a restrictive policy on the use of medicines in pregnancy but not so that pregnant women fail to use necessary prescribed medication such as penicillin for a urinary tract infection, or that they would prefer to use herbal remedies,” says Nordeng.
“It is important that both health-care professionals and health authorities understand how women's risk perceptions can affect decisions about medicine use during pregnancy and the breastfeeding period," said Nordeng.
Women with health-related occupations were more confident in their doctor than pregnant women with other occupations. Pregnant women with a higher education were more sceptical to herbal remedies than women with a lower education.
No correlation between knowledge and risk assessment
The researchers were not surprised that pregnant women and mothers of infants overestimate the risk of birth defects with the use of specific medicines, foods and chemicals.
“More surprising was the fact that almost nine out of ten had a correct assessment of the teratogenic risk in general. Thus, there was a “mismatch”: They understand that birth defects are rare, but when they take a medicine many believe that they immediately expose the foetus to an increased risk of birth defects - even by the use of safe medicines like penicillin," said Nordeng.
Medicines for depression and sleep problems were considered to be the most dangerous medicines. There was a clear relation between their own consumption of medicines and how they rated the risk of medicine use – for their own pregnancy, use of medicines was rated as consistently less risky.
About the study
The study looked at women's perception of the risks of medicines and other substances during pregnancy. The findings confirm earlier findings from Spain and Canada that show the same tendencies.
The study was conducted via an online questionnaire in the period September 2008 - October 2008. The women were recruited from four websites for pregnant women. A total of 1793 women took part in the study. Of these, 866 women (48.3 percent) were pregnant and 927 (51.7 percent) were mothers with at least one child under 5 years of age.
These women were asked to rate the risk of 17 different medicines, foods, smoking, alcohol and other substances on a scale from 0 (safe to use) to 10 (always harmful to the foetus).
The women were also asked to consider 16 statements about medicines. Seven statements were of a general nature and nine statements applied to use in pregnancy.
They provided information about their own medicine use in pregnancy and about their own background with regards to age, number of children, marital status, education, career, intake of alcohol and smoking habits during pregnancy. The women's socio-demographic backgrounds reflected the general Norwegian birth population, with the exception of education level. The women in the study had a higher education compared with the average education level among women in Norway aged 25 to 29 years.
The study is a collaboration between the Norwegian Institute of Public Health, the University of Oslo and the researchers at Motherisk at the Hospital for Sick Children in Toronto, Canada.
Perception of risk regarding the use of medications and other exposures during pregnancy. Eur J Clin Pharmacology 2010; 66: 207-14. Hedvig Nordeng & Eivind Ystrøm & Adrienne Einarson
Pregnant women's beliefs about medications - A study among 866 Norwegian women by Hedvig Nordeng, Gideon Koren, Adrienne Einarson. Annals of Pharmacotherapy online.