Assessment of medication use during pregnancy by Web-based questionnaires, pharmacy records and serum screening

Assessment of knowledge, attitude, and practice on self-care with over-the-counter medicines among pregnant women

Background

Self-care during pregnancy is a crucial topic to be discussed due to its effects on both the mother and fetus. In Sri Lanka, specifically regarding self-care with over-the-counter (OTC) medicines, usage among the pregnant population is scarce.

Objective

This study assessed knowledge, attitudes, and practices (KAP) on self-care with OTC medicine usage among pregnant women attending maternity clinics in the Colombo Medical Officer of Health (MOH) areas, Sri Lanka.

Method

A cross-sectional study was conducted among 399 pregnant women enrolled through simple random sampling using a self-administered questionnaire. Data were collected on knowledge, attitudes, practices, and sociodemographic characteristics. SPSS version 27 was used for descriptive statistical analysis.

Results

There were satisfactory levels of KAP on self-care with OTC medicines identified among participants. The Mean ± SD for knowledge was 4.38 ± 0.873, and for attitude and practice, 27.56 ± 3.752 and 20.35 ± 4.235, respectively. Significant positive linear correlation between knowledge and attitude (r = 0.375, p < 0.001), attitude and practice (r = 0.518, p < 0.001), and knowledge and practice (r = 0.224, p < 0.001) were observed. It refers to participants with higher levels of knowledge being more likely to exhibit certain attitudes and engage in good practice regarding self-care. However, 93% of the participants had a wrong intention that any medicine could be used at any stage of pregnancy, and 26.3% of the participants didn't know that the medications taken during pregnancy could impact the fetus. Surprisingly, 87% had misperceived that antibiotics can be purchased as OTC medicines. Additionally, the majority of the participants (96%) believed that they could use old prescriptions to purchase medicines during pregnancy.

Conclusion

Greater awareness regarding self-care with OTC medication usage is suggested to be provided during pregnancy.

The PRIDE Study: Evaluation of online methods of data collection

BACKGROUND

Large birth cohort studies are extremely valuable in assessing associations between early life exposures and long-term outcomes. Establishing new birth cohorts is challenging due to declining participation rates. Online methods of data collection may increase feasibility, but have not been evaluated thoroughly.

OBJECTIVE

The primary objective of the ongoing PRegnancy and Infant DEvelopment (PRIDE) Study is to identify exposures during pregnancy and in early life that may affect short-term or long-term health of mother and/or child. In this manuscript, we aimed to evaluate methods of recruitment and online data collection applied.

POPULATION

Dutch women aged ≥18 years in early pregnancy.

DESIGN

Prospective cohort study.

METHODS

Initially, only prenatal care providers recruited participants, but alternative recruitment methods were added as a result of disappointing participation rates, including collaboration with "Moeders voor Moeders" (organisation that visits women in early pregnancy) and Facebook advertisements. Data on demographic characteristics, obstetric history, maternal health, life style factors, occupational exposures, nutrition, pregnancy complications, and infant outcomes are primarily collected through Web-based questionnaires at multiple time points during and after pregnancy. Additional data collection components include paternal questionnaires, blood and saliva sampling, and linkage to medical records.

PRELIMINARY RESULTS

By September 2019, 9573 women were included in the PRIDE Study, of which 1.3% completed paper-based questionnaires. Mean age of the women analysed was 30.6 years, 71.1% had a high level of education, 57.2% were primiparae, and mean gestational age at enrolment was 9.9 (range 3, 37) weeks, with slight differences between recruitment methods. Pregnancy outcome was known for 89.8%. Retention rate at 6 months after the estimated date of delivery was estimated at 70%. Multiple validation studies conducted within the PRIDE Study indicated high data quality.

CONCLUSION(S)

Although challenging and time-consuming, online methods for recruitment and data collection may enable the establishment of new birth cohort studies.

Low-dose-aspirin usage among women with an increased preeclampsia risk: A prospective cohort study

INTRODUCTION

Low-dose aspirin (LDA) prophylaxis has been shown to reduce women's preeclampsia risk. Evidence regarding LDA adherence rates of pregnant women is based almost exclusively on clinical trials, giving a potentially biased picture. Moreover, these studies do not report on determinants of adherence. Since 2017, obstetric healthcare professionals in a Dutch region have assessed women's preeclampsia risk by means of a prediction tool and counseled those with an above-population average risk on LDA as a prophylactic measure.

MATERIAL AND METHODS

From 2017 to 2018, 865 women were recruited in multiple centers and prospectively followed using web-based surveys (Expect Study II). Rates and determinants of LDA usage among women with an increased preeclampsia risk in daily practice were assessed. Results were compared with findings in a similar cohort from a care-as-usual setting lacking risk-based counseling (Expect Study I, n = 2614). Netherlands Trial Register NTR4143.

RESULTS

In total, 306 women had a predicted increased preeclampsia risk. LDA usage was higher for women receiving risk-based care than care-as-usual (29.4% vs 1.5%, odds ratio 19.1, 95% confidence interval 11.2-32.5). Daily LDA usage was positively correlated with both predicted risk and women's concerns regarding preeclampsia. Most reported reasons for non- or incomplete use were unawareness of LDA as a preventive intervention, concerns about potential adverse effects and doubts regarding the benefits.

CONCLUSIONS

Risk-based counseling was associated with a higher prevalence of LDA usage, but general usage rates were low. Future research regarding potential factors improving the usage of LDA during pregnancy is necessary.