Drug use during pregnancy

Use of medicines with unknown fetal risk among parturient women from the 2004 Pelotas Birth Cohort (Brazil)

Background. To estimate the exposure to medicines with unknown fetal risk during pregnancy and to analyze the maternal characteristics associated with it. Methods. A questionnaire was administered to 4,189 mothers of children belonging to the 2004 Pelotas (Brazil) birth cohort study about use of any medicine during gestation. We evaluated the associations between use of medicines with unknown fetal risk and the independent variables through logistic regression models. Unknown fetal risk was defined as medicines in which studies in animals have revealed adverse effects on the fetus, and no controlled studies in women, or studies in women and animals, are available. Results. Out of the 4,189 women, 52.5% used at least one medicine from unknown fetal risk. Use of these medicines was associated with white skin color, high schooling, high income, six or more antenatal care consultations, hospital admission during pregnancy, and morbidity during gestation. Conclusion. The use of unknown fetal risk medicines is high, suggesting that their use must be addressed with caution with the aim of restricting their use to cases in which the benefits are greater than the potential risks.

[Perinatality in the context of addictions]

We must remove bad representations the medical team has upon the pregnant drug users and the same way in reverse. Opiate substitution treatment (OST) improves prenatal prognosis for both mother and child. There is no need to change OST for a stabilized woman discovering pregnancy. Nevertheless, buprenorphine appears to be first-range medication. OST posology is the most important for prenatal prognosis. Practician must never hesitate to adapt it whether increasing or fractionate it. Neonatal abstinence syndrome (NAS) is not linked with OST's posology. OST is not contra-indicated for breast-feeding. Breast-feeding should be encouraged. It does not treat or cure NAS but allows a skin-to-skin contact that could lessens an occurring withdrawal.