General Obstetrics and Gynecology Obstetrics
Prescription, over-the-counter, and herbal medicine use in a rural, obstetric population

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Abstract

Objective: The purpose of this study was to identify the medications that are consumed by a rural obstetric population during pregnancy. Study Design: Over a period of 26 months, pregnant women were interviewed about medication use. Interviews on subsequent visits provided a longitudinal study of medication usage and discontinuation. Trend differences were analyzed according to the number of medications, the trimester of use, and insurance status. Results: Five hundred seventy-eight participants had 2086 interviews. The compilation of the interviews showed that 95.8% of the participants took prescription medications, 92.6% of the participants self-medicated with over-the-counter medications, and 45.2% of the participants used herbal medications. Over time, consumption of over-the-counter medications exceeded prescription medication use. Fifteen percent of the pregnant women took ibuprofen at some point during the pregnancy (5.7% in the third trimester). Eight percent of the women were noncompliant and 20% incompletely compliant with prenatal vitamin and mineral formulations. Conclusion: Medication use was substantial in this population. Medications (eg, ibuprofen) that are contraindicated in pregnancy were used at unexpectedly high rates. Of the three medication classes, over-the-counter medications were used most frequently. (Am J Obstet Gynecol 2003;188:1039-45.)

Section snippets

Methods

Interview and study protocols were approved by the West Virginia University Institutional Review Board for the Protection of Human Research Subjects; all subjects gave written, informed consent before participating. Subjects were recruited from four rural outreach clinics and the Physician's Office Center (also serving a predominantly rural population) of West Virginia University. No portion of the catchment area is considered urban, including the university-based clinic. The rural outreach

Results

Because of the longitudinal nature of the investigation, 2086 patient encounters were recorded. Demographic data are reported in Table I.It is noteworthy that the ethnic representation of participants in the study is congruent with that of the state of West Virginia as a whole (according to 2000 US Census information). The mean gestational age at enrollment was 17.5 weeks. As noted in Table I, 33.6% of the participants received only one interview. This figure includes those obstetric patients

Comment

Pregnant women frequently take medications that are prescribed by physicians other than the obstetrics care provider. In a study of antibiotic usage by pregnant women, Glover and Larsen6 reported that emergency and family medicine physicians prescribed approximately 40% of the antibiotics that are consumed by obstetric patients. Women who take long-term medications (such as thyroxin, antihistamines, or psychotropic agents) may not inform the obstetrician about their use. Medicating with

Acknowledgements

We thank Dr William Ledger and Dr Gilles Monif for their helpful comments during the preparation of this manuscript; we thank especially the numerous Doctor of Pharmacy students who conducted the subject interviews.

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Reprint requests: Timothy S. Tracy, PhD, Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26506. E-mail: [email protected]

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