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Judistiani RTD, Pratiwi AE, Wahyudi K, Gunawan A, Rahmawati A, Ruslami R. Medication Use and Associated Factors Among Indonesian Pregnant Women: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:4173-4179. [PMID: 38146360 PMCID: PMC10749785 DOI: 10.2147/jmdh.s440426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Medication use during pregnancy should be considered carefully due to its potential harm to the fetus. Data on prescribed medication and self-medication among Indonesian pregnant women is lacking. This study aimed to assess the prevalence and factors related to medication use among pregnant women attending antenatal care services at community health posts in Soreang, a suburban area in Indonesia. Patients and Methods A cross-sectional community-based study was conducted. Data on medication use, excluding supplements, were collected. Medication was categorized using the former United States Food and Drug Administration (US FDA) pregnancy risk classification system. Proportions of pregnant women using prescribed medication and self-medication during pregnancy and associated factors were calculated. Results A total of 439 pregnant women were enrolled. There were 155 (35.5%) subjects who used at least one medication during pregnancy. These subjects had medical problems as the reasons for medication use. Among medication users, prescribed medication and self-medication were demonstrated in 138 (89.0%) and 17 (11.0%) pregnant women, respectively. There was a pregnant woman who was exposed to category D medication. Self-medication among pregnant women was less likely when health insurance was available (adjusted OR = 0.11, 95% CI: 0.027-0.413, P = 0.001). Conclusion The prevalence of medication use among Indonesian pregnant women is high. The presence of health insurance was protective against self-medication among pregnant women. Safe and effective practices in prescribing have to be ensured for pregnant women.
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Affiliation(s)
- Raden Tina Dewi Judistiani
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Centre for Clinical Infection Studies, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Aprilya Eka Pratiwi
- Magister in Epidemiology Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Kurnia Wahyudi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Agnesya Gunawan
- Centre for Clinical Infection Studies, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Anita Rahmawati
- Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Rovina Ruslami
- Centre for Clinical Infection Studies, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Rajan B, Pasangha E, Devi P, George S. Patterns of Medication Use and Their Determinants in Pregnancy among Women Admitted to the Obstetrics Wards of a Tertiary Care Hospital: A Cross-Sectional Study: Patterns of Medication Use and Their Determinants in Pregnancy. J Pharmacol Pharmacother 2023. [DOI: 10.1177/0976500x221147803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background To assess the patterns and factors affecting medication use during antenatal and perinatal periods and to examine maternal and fetal outcomes among pregnant women admitted to a tertiary care hospital in a developing country. Methods A cross-sectional study was conducted in the obstetrics wards from 2017 to 2019. Data on patient demographics, co-existent medical conditions, medications, and patient outcomes were collected. Descriptive statistics were used to analyze baseline data, chi-square test was used for categorical variables, and multivariate logistic regression was used for factors influencing drug prescription. Results Out of 442 pregnant women, 56% were primigravida with a mean age of 24.7 ± 3.9 years. Approximately 32% experienced at least one disease condition during pregnancy; hypothyroidism (9.7%) was the commonest. The mean number of medications was 2.7 and 38.9% received drugs for a disease condition. Antimicrobials (24.5%) were the commonest drug class. Maternal age of over 25 [(OR (CI): 1.508 (1.191–2.716) ( p = .005)] and maternal illness [OR (CI) 2.934 (1.8–4.7) ( p = .00)] were identified as factors affecting drug prescription. Approximately 39.8% of deliveries were cesarean. Of the newborns, 12.6% had low birth weight, 9.2% were admitted to the newborn intensive care unit, and 14.9% were premature. Conclusions Most patients were primigravida and under 25 years. Antimicrobials were the most prescribed drug class. Maternal age over 25 years and maternal illness were identified as the factors affecting medication use. The prevalence of cesareans and prematurity was similar to previous studies.
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Affiliation(s)
- Boney Rajan
- Department of Pharmacology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Elaina Pasangha
- St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Padmini Devi
- Department of Pharmacology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Shirley George
- Department of Obstetrics and Gynaecology, St John’s National Academy of Health Sciences, Bangalore, Karnataka, India
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Belete TM, Gashaw sisay, Mengesha E, Dandena A, Simegn W, Mengesha AK, Basazin A. Prescription pattern and associated factors among pregnant women attending antenatal clinics in University of Gondar, North West Ethiopia. Heliyon 2022; 8:e12156. [PMID: 36561705 PMCID: PMC9764175 DOI: 10.1016/j.heliyon.2022.e12156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/20/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
Background An inappropriate use of drug during pregnancy may harm the fetus. There is no enough study on drug use among pregnant women at the University of Gondar referral hospital. Most studies are carried out in developed countries but not in developing countries. Thus, the aim of this study was to evaluate prescription of drug and associated factors among pregnant women attending antenatal care service in University of Gondar referral hospital. Methods Institution based cross sectional study was used among 334 pregnant women who attended antenatal care units of the University of Gondar referral hospital. Data were collected from the pregnant women medical records and registration logbook and analyzed using SPSS version 23. Multivariate logistic regression used to analyze the association of the independent variables with drug use. P-values <0.05 were considered significant. Result A total of 334 pregnant women's medical records showed a total of 631 drugs prescribed. The average numbers of drugs per pregnant women was 1.88. All pregnant women (100%) were prescribed with iron folat. Most pregnant women 185 (55.2%) were in the third trimester followed by third trimester 91 (27.25%). Moreover, 23.77%, 42.95%, 33%, and 7% pregnant women encountered with drugs from category A, B, C and D respectively. From the bivariate regression analysis, Age of women, maternal illness, trimester at the first visit, and gravidity were significantly associated with exposure to prescribed drug use during pregnancy. Conclusion The present study showed the deviation of drug use pattern from the WHO optimal levels proposing the hospitals had inappropriate use of drug. Implementing corrective measures are required to achieve the recommended standards of appropriate drug use.
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Mulu GB, Atinafu BT, Tarekegn FN, Adane TD, Tadese M, Wubetu AD, Kebede WM. Factors Associated With Neural Tube Defects Among Newborns Delivered at Debre Berhan Specialized Hospital, North Eastern Ethiopia, 2021. Case-Control Study. Front Pediatr 2021; 9:795637. [PMID: 35295317 PMCID: PMC8918646 DOI: 10.3389/fped.2021.795637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Neural tube defects are severe congenital malformations secondary to an abnormal closure of the neural tube between third and fourth weeks of gestational ages. Neural tube defects affect birth outcomes worldwide, with an occurrence of 18.6 per 10,000 live births. In addition, neural tube defects are associated with considerable mortality, morbidity, disability, and socio-economical cost. OBJECTIVE To identify factors associated with neural tube defects among newborns delivered at Debre Berhan Comprehensive Specialized Hospital, 2021. METHODS Facility-based case-control study design was conducted among 381 (127 cases and 254 controls) newborns delivered from June 2019 to June 2021 at Debre Berhan Specialized Hospital. Consecutive and systematic random sampling techniques were used to select cases and controls, respectively. Data were collected using semi-structured checklists. Finally, data were entered using Epidata version 4.2.1 and analyzed using SPSS version 25. In the bivariable logistic regression model, factors with a p < 0.20 were entered into multivariable logistic regressions. Statistical significance was declared at a p < 0.05. RESULT In this study, 381 newborns (127 cases and 254 controls) participated with a response rate of 100%. In the logistic regression model, mothers who took medication during pregnancy [AOR 1.83 (95% CI 1.08-3.08)], mothers who did not take a balanced diet during pregnancy [AOR 13.46 (95% CI 7.83-23.13)], and mothers who did not take folic acid before and during the first trimester of pregnancy [AOR 1.71 (95% CI 1.01-2.94)] were significantly associated with neural tube defect. CONCLUSION AND RECOMMENDATION Mothers who took medication during pregnancy, mothers who did not take balanced diets during pregnancy, and mothers who did not take folic acid during pregnancy were the significant factors of neural tube defects. Health care professionals should focus on maternal safe drug prescription, maternal folate intake, and a balanced diet before and during pregnancy.
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Affiliation(s)
- Getaneh Baye Mulu
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantalem Tilaye Atinafu
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Nigussie Tarekegn
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tigist Demssew Adane
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mesfin Tadese
- Department of Midwifery, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abate Dargie Wubetu
- Department of Pyschiatry, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
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Alema NM, Semagn G, Melesse S, Araya EM, Gebremedhin H, Demsie DG, Asgedom SW, Weldekidan E. Patterns and determinants of prescribed drug use among pregnant women in Adigrat general hospital, northern Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth 2020; 20:624. [PMID: 33059613 PMCID: PMC7558672 DOI: 10.1186/s12884-020-03327-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background A vigilant prescription of drugs during pregnancy can potentially safeguard the growing fetus from the deleterious effect of the drug while attempting to manage the mother’s health problems. There is a paucity of information about the drug utilization pattern in the area of investigation. Hence, this study was implemented to investigate the pattern of drug utilization and its associated factors among pregnant women in Adigrat general hospital, Northern Ethiopia. Methods An institution-based cross-sectional study was conducted among randomly selected 314 pregnant women who attended obstetrics-gynecology and antenatal care units of the hospital. Relevant data were retrieved from the pregnant women’s medical records and registration logbook. The drugs prescribed were categorized based on the United States Food and Drug Administration (US-FDA) fetal harm classification system. Data analysis was done using SPSS version 20 statistical software. Multivariate logistic regression was employed to analyze the association of the explanatory variables with the medication use, and p < 0.05 was declared statistically significant. Results The overall prescribed drug use in this study was found to be 87.7%. A considerable percentage of the study participants (41.4%) were prescribed with supplemental drugs (iron folate being the most prescribed drug) followed by antibiotics (23.4%) and analgesics (9.2%). According to the US-FDA drug’s risk classification, 42.5, 37, 13, and 7% of the drugs prescribed were from categories A, B, C, and D or X respectively. Prescribed drug use was more likely among pregnant women who completed primary [AOR = 5.34, 95% CI (1.53–18.6)] and secondary education [AOR = 4.1, 95% CI (1.16–14)], who had a history of chronic illness [AOR = 7.9, 95% CI (3.14–19.94)] and among multigravida women [AOR = 2.9, 95% CI (1.57 5.45)]. Conclusions The finding of this study revealed that a substantial proportion of pregnant women received drugs with potential harm to the mother and fetus. Reasonably, notifying health practitioners to rely on up-to-date treatment guidelines strictly is highly demanded. Moreover, counseling and educating pregnant women on the safe and appropriate use of medications during pregnancy are crucial to mitigate the burden that the mother and the growing fetus could face.
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Affiliation(s)
- Niguse Meles Alema
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia.
| | - Getachew Semagn
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
| | - Shetey Melesse
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
| | - Ephrem Mebrahtu Araya
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
| | - Hagazi Gebremedhin
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
| | - Desalegn Getnet Demsie
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
| | - Solomon Weldegebreal Asgedom
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Etasy Weldekidan
- Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, P.O.Box: 50, Adigrat, Ethiopia
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Ayele Y, Mekuria AN, Tola A, Mishore KM, Geleto FB. Prescription drugs use during pregnancy in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2020; 8:2050312120935471. [PMID: 32612829 PMCID: PMC7307276 DOI: 10.1177/2050312120935471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/21/2020] [Indexed: 01/13/2023] Open
Abstract
Background The selection of safe drugs for pregnant women in developing countries, such as Ethiopia, where there are limited options of drugs would be challenging. Hence, the aim of this review was to determine the extent of prescribed drugs use and their potential to cause fetal harm among pregnant women in Ethiopia based on the United States Food and Drug Administration risk category. Methods Relevant studies were identified through systematic searches conducted in PubMed, HINARI, Google Scholar and Researchgate. Data on study characteristics and outcomes were extracted using the format developed in Microsoft Excel. The primary measure was pooled prevalence of prescription drugs use during pregnancy. The I2 index was used to assess heterogeneity among studies. The presence of publication bias across studies was evaluated using funnel plot. A random effects model was used to estimate the pooled prevalence. Results A total of nine studies published between 2013 and 2019 were included. The pooled prevalence of prescription drugs during pregnancy, excluding minerals and vitamins, was 45.9 (95%CI: 29.3, 62.5)%. The pooled prevalence of prescription drug use, including minerals and vitamins, was 86.9 (95%CI: 81.2, 92.6)%. The pooled proportion of medications used based on the United States Food and Drug Administration risk category was 56.1 (95%CI: 43.0, 68.4)%, 29.0 (95%CI: 27.9, 30.1)%, 12.1 (95%CI: 7.9, 18.1)%, 4.1 (95%CI: 3.6, 4.6)%, and 2.5 (95%CI: 1.8, 3.6)% for the United States Food and Drug Administration fetal risk category "A," "B," "C," "D," and "X," respectively. Conclusion The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. Drugs with evidence of fetal harm were widely used. Hence, health care providers should select relatively safe drugs. Stakeholders should ensure safe prescribing practice for pregnant women through developing guidelines and updating professionals on the fetal risk status of commonly prescribed drugs.
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Affiliation(s)
- Yohanes Ayele
- Department of Clinical Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Nigussie Mekuria
- Department of Pharmacology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Assefa Tola
- Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kirubel Minsamo Mishore
- Department of Clinical Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fisseha Bonja Geleto
- Department of Medical laboratory, College of medicine and health science, Hawassa University, Hawassa, Ethiopia
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Alemu BK, Wolle NN. Prescription drug use and potential teratogenicity risk among pregnant women attending maternal and child health clinic of Kemisse General Hospital, Northeast, Ethiopia. BMC Res Notes 2019; 12:592. [PMID: 31533806 PMCID: PMC6751805 DOI: 10.1186/s13104-019-4641-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/11/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate medications prescribed for pregnant women and their potential teratogenicity risk in Kemisse General Hospital. RESULT A total of 263 medical records of pregnant women were reviewed, of which 234 pregnant women were prescribed with a total of 430 prescription drugs. The average numbers of drugs per pregnant women was found to be 1.84. Most pregnant women 166 (63.2%) were in the third trimester and more than half of them (51.3%) were multigravida. The maximum number of drugs were prescribed in the second trimester 162 (37.67%) followed by third trimester 143 (33.26%). Supplemental drugs were the most widely used medications 297 (69.07%) and followed by 82 (19.1%) drugs from category B; 54 (12.6%) drugs from category C; and the rest 7 (1.6%) drugs from category D. There was no any drug from category X. Moreover, approximately one third of the pregnant women encountered with drugs from category B, C and D. However, there were no FDA category C and D drugs prescribed in first trimester.
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Affiliation(s)
- Belete Kassa Alemu
- Department of Pharmacy, Pharmacology and Toxicology Unit, College of Medicine and Health Sciences, Wollo University, P.o.box 1145, Dessie, Ethiopia.
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Bedewi N, Sisay M, Edessa D. Drug utilization pattern among pregnant women attending maternal and child health clinic of tertiary hospital in eastern Ethiopia: Consideration of toxicological perspectives. BMC Res Notes 2018; 11:858. [PMID: 30514377 PMCID: PMC6280540 DOI: 10.1186/s13104-018-3966-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/29/2018] [Indexed: 02/03/2023] Open
Abstract
Objective This study is aimed to investigate drug utilization pattern among pregnant women attending maternal and child health clinic of tertiary hospital in eastern Ethiopia from March 1 to April 20, 2018. Result A total of 369 pregnant women medical records were reviewed. The mean age of pregnant women was 24.34 (± 4.48) years and the majority of them were within the age of 18-25 years. About three-fourths (n = 277, 75.1%) of them were urban residents. Besides, 314 (85.1%) women had taken at least one drug with a total of 377 drugs prescribed. From which, supplemental drugs accounted majority of the drug therapy (84.88%) whereas non-supplemental drugs (15.12%) were used by 41 pregnant women during the review period. According to Food and Drug Administration FDA pregnancy risk classification, 320 (84.88%) drugs were prescribed from category A; 33 (8.75%) drugs were from category B; 19 (5.04%) drugs were from category C and 5 (1.33%) drugs were from category D. There was no drug prescribed from category X. As this result indicated, there is a decrease in the prevalence of drug use from Category A to X as the possibility of potential risk to fetus might outweigh the potential benefit to the mother. Some drugs were utilized from category D for treatment of chronic illnesses. Electronic supplementary material The online version of this article (10.1186/s13104-018-3966-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Neim Bedewi
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O.Box, 235, Harar, Ethiopia
| | - Mekonnen Sisay
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O.Box, 235, Harar, Ethiopia.
| | - Dumessa Edessa
- Department of Pharmacy Practice, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, Ethiopia
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Leke AZ, Dolk H, Loane M, Casson K, Maboh NM, Maeya SE, Ndumbe LD, Nyenti PB, Armstrong O, Etiendem D. First trimester medication use in pregnancy in Cameroon: a multi-hospital survey. BMC Pregnancy Childbirth 2018; 18:450. [PMID: 30458752 PMCID: PMC6245902 DOI: 10.1186/s12884-018-2081-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/31/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is a paucity of epidemiological data on medication use in pregnancy in Cameroon. METHODS Between March and August 2015, 795 pregnant women attending 8 urban and 12 rural hospitals in Cameroon for antenatal (ANC) or other care were interviewed on first trimester medication use using structured questionnaires. Multivariate logistic regression was used to analyse the association of 18 sociodemographic factors with medication use. RESULTS A total of 582 (73.2%) women took at least one orthodox (Western) medication during the first trimester, 543 (68.3%) women a non-pregnancy related orthodox medication, and 336 (42.3%)women a pregnancy related orthodox medication. 44% of the women took anti-infectives including antimalarials (33.6%) and antibiotics (20.8%).The other most common medications were analgesics (48.8%) and antianaemias (38.6%). Sulfadoxine/pyrimethamine, contraindicated in the first trimester of pregnancy, was the most commonly used antimalarial(13% of women).0.2% of women reported antiretroviral use. Almost 80% of all orthodox medications consumed by women were purchased from the hospital. 12.8% of the women self-prescribed. Health unit and early gestational age at ANC booking were consistent determinants of prescribing of non-pregnancy related, pregnancy related and anti-infective medications. Illness and opinion on the safety of orthodox medications were determinants of the use of non-pregnancy related medications and anti-infectives. Age and parity were associated only with non-pregnancy related medications. CONCLUSION This study has confirmed the observations of studies across Africa indicating the increasing use of medications during pregnancy. This is an indication that access to medicine is improving and more emphasis now must be placed on medication safety systems targeting pregnant women, especially during the first trimester when the risk of teratogenicity is highest.
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Affiliation(s)
- Aminkeng Zawuo Leke
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
- Office of the Deputy Vice Chancellor i/c Research/Cooperation/Quality, Biaka Universit Institute of Buea, PO Box 77-SWR, Buea, Cameroon
| | - Helen Dolk
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Shore Rd Newtownabbey, BT370QB Ulster, Ireland
| | - Maria Loane
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Shore Rd Newtownabbey, BT370QB Ulster, Ireland
| | - Karen Casson
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Shore Rd Newtownabbey, BT370QB Ulster, Ireland
| | - Nkwati Michel Maboh
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
| | - Susan Etta Maeya
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
| | - Lerry Dibo Ndumbe
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
| | - Pauline Bessem Nyenti
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
| | - Obale Armstrong
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
| | - Derick Etiendem
- Department of Nursing, School of Health Sciences, Biaka University Institute of Buea-Cameroon, PO BOX 77, Buea, Cameroon
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Navaro M, Vezzosi L, Santagati G, Angelillo IF. Knowledge, attitudes, and practice regarding medication use in pregnant women in Southern Italy. PLoS One 2018; 13:e0198618. [PMID: 29920515 PMCID: PMC6007931 DOI: 10.1371/journal.pone.0198618] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/22/2018] [Indexed: 12/31/2022] Open
Abstract
The study assessed knowledge, attitudes, and medication use of a random sample of pregnant women attending outpatient Gynecology and Obstetrics clinics at randomly selected public General and Teaching hospitals in Naples, Italy. A total of 503 women participated. Those more likely to know that a pregnant woman with chronic condition must discuss whether or not to take a medication with the physician were Italian, aged 31-40 years, employed, with no history of abortion, having had a medical problem within the previous year, with a better self-perceived health status, who knew how to use medications during pregnancy, and who needed information on medications. The knowledge of the potential risk of using non-prescribed medications during pregnancy was significantly higher in employed women, who received information from physicians, who knew how to use medications during pregnancy, and who knew the possible damages related to medications use. More than half had used at least one medication. Those aged 26-35 years, Italian, non-graduated, in the third trimester, having had a medical problem within the previous year, with a risky pregnancy, and with a knowledge that women with chronic condition must discuss whether or not to take a medication with the physician were more likely to use medication. Less than half had used medication without a physician's advice. Those who were more likely to self-medicate were older, Italian, multiparous, with no history of abortion, who knew that women with chronic condition must discuss whether or not to take a medication with the physician, who did not know the potential risk of using non-prescribed medication during pregnancy, who had used prescribed medication during pregnancy, and who needed information about medications. Educational programs for women about medication use are important to increase their knowledge of the potential risks to the pregnant women and the unborn child in order to reduce self-medication.
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Affiliation(s)
- Monica Navaro
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luigi Vezzosi
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gabriella Santagati
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Italo Francesco Angelillo
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
- * E-mail:
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Taye M, Afework M, Fantaye W, Diro E, Worku A. Factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia: a case-control study. BMC Pediatr 2018; 18:142. [PMID: 29699508 PMCID: PMC5921791 DOI: 10.1186/s12887-018-1096-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/20/2018] [Indexed: 12/02/2022] Open
Abstract
Background The early stage of embryo development is extremely vulnerable to various teratogenic factors, leading to congenital anomalies. In Ethiopia, a significant number of babies are born with congenital anomalies, but the risk factors for the anomalies have never been studied. Understanding the specific risk factors for congenital anomalies is very essential to provide health education that aims at creating awareness and establishing preventive strategic plan/s. The main objective of this study was to assess the risk factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia. Methods A case-control study was conducted from January 1- June 30, 2015. The participants were recruited at the purposively selected hospitals in Addis Ababa and the Amhara Region. A total of 207 cases and 207 controls were included in the study. Cases were neonates, infants, and children 0-11 months of age with external and internal major congenital anomalies diagnosed by pediatricians. Controls were neonates, infants, and children 0-11 months of age without external and internal anomalies. Data on sociodemographic characteristics, exposure to risk factors, and reproductive history were collected by face to face interviews with children’s mothers/caregivers using a structured questionnaire. Binary logistic regression was employed to explore risk factors associated with the occurrence of the problems. Results About 87.4% of the children were below 6 months, and 12.6% were between 6 and 11 months. The majority (59.9%) of the children were male, with the M: F sex ratio of 1.49. The mean age of the mothers was 26 years (16-45 years). Unidentified medication use during early pregnancy (AOR = 4.595; 95% CI: 1.868-11.301, P-value = 0.001), maternal alcohol drinking (AOR = 2.394; 95% CI: 1.212-4.726, P-value = 0.012), and exposure to chemicals (AOR = 9.964; 95% CI = 1.238-80.193, P-value = 0.031) were significantly associated with the occurrence of congenital anomalies. Iron folate use (AOR = 0.051; 95% CI: 0.010-0.260, P-value = < 0.001) before and during early pregnancy had a protective effect on congenital anomaly. Conclusion Unidentified medication use, alcohol drinking during early pregnancy, and exposure to chemicals had a significant association with the occurrence of congenital anomalies, whereas iron folate use before and during early pregnancy had a protective effect from congenital anomalies.
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Affiliation(s)
- Molla Taye
- Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, the University of Gondar, Gondar, Ethiopia.
| | - Mekbeb Afework
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondwossen Fantaye
- School of Dentistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ermias Diro
- School of Medicine, College of Medicine and Health Sciences, the University of Gondar, Gondar, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Molla F, Assen A, Abrha S, Masresha B, Gashaw A, Wondimu A, Belete Y, Melkam W. Prescription drug use during pregnancy in Southern Tigray region, North Ethiopia. BMC Pregnancy Childbirth 2017; 17:170. [PMID: 28583106 PMCID: PMC5460343 DOI: 10.1186/s12884-017-1359-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 05/26/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Judicious utilization of drugs rescues the fetus from the harmful effects while treating the health problems of the pregnant women. This study aimed at evaluating drug utilization pattern and its associated factors among pregnant women in Southern Tigray, Ethiopia. METHOD Institution based cross-sectional study was conducted among 647 pregnant women who had been attending obstetrics-gynecology and antenatal care units in different health facilities of Southern Tigray region. The study participants were selected using multistage sampling technique. Data collection was done using pre-tested semi-structured questionnaires and by reviewing antenatal follow-up cards. Descriptive and inferential statistics were analyzed, to assess drug utilization pattern and its associated factors among pregnant women, using SPSS version 20 software. RESULTS Of 647 pregnant women, 87.5% were prescribed with at least one medication. As per the United States Food and Drug Administration (US-FDA) risk classification system, 87.7, 7.9, 3.9, and 0.5% of the prescribed drug were from category A, B, C and D, respectively. Prescription drug use was more likely among gynecology ward visitors [AOR = 8.97, 95% Cl (2.69-29.88)] and among those who visited health facilities for the first time during their first [AOR =2.65, 95% Cl (1.44-4.84)] and second [AOR = 2.50, 95% Cl (1.36-4.61)] trimesters. CONCLUSION Majority of the study population used safe and appropriate medications according to US-FDA risk classification system, with the exception of low proportion (0.5%) of medication with potential risk for the fetus. The average number of drug prescribed per pregnant women was in the recommended range of WHO drug use indicators guideline.
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Affiliation(s)
- Fantahun Molla
- Pharmaceutics Department, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Admassu Assen
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Solomon Abrha
- Pharmaceutics Department, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Birhanetensay Masresha
- Pharmacology and Toxicology Department, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Arega Gashaw
- Clinical Pharmacy Unit, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Abrham Wondimu
- Pharmaceutics Department, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Yared Belete
- Social Pharmacy and Pharmacoepidemiology Unit, School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia
| | - Wondim Melkam
- Pharmacology Department, College of Medicine & Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
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