Drug use before and during pregnancy in Serbia

Odalovic, Marina, Kovacevic, Sandra Vezmar, Ilic, Katarina, Sabo, Ana and Tasic, Ljiljana (2012) Drug use before and during pregnancy in Serbia. International Journal of Clinical Pharmacy, 34 5: 719-727. doi:10.1007/s11096-012-9665-8

Author Odalovic, Marina
Kovacevic, Sandra Vezmar
Ilic, Katarina
Sabo, Ana
Tasic, Ljiljana
Title Drug use before and during pregnancy in Serbia
Journal name International Journal of Clinical Pharmacy   Check publisher's open access policy
ISSN 2210-7703
Publication date 2012-10
Year available 2012
Sub-type Article (original research)
DOI 10.1007/s11096-012-9665-8
Open Access Status Not yet assessed
Volume 34
Issue 5
Start page 719
End page 727
Total pages 9
Place of publication Dordrecht, Netherlands
Publisher Springer Netherlands
Language eng
Formatted abstract
Background: Observation of drug use patterns during pregnancy is necessary for the recognition of potential bad practices and improvement of safe drug use in pregnancy.

Objective: To investigate prescription and over the counter drug use among Serbian women in the 6 months before pregnancy and in the first 6 months of pregnancy, and to evaluate the drugs used according to the risk to a fetus.

Setting: Six maternity care units and five community pharmacies 

Method: A multi-center study was performed in Serbia during the period from March 2009-March 2010. A self-reporting questionnaire was used as a data source. Food and Drug Administration (FDA) risk classification system was used to determine the risk of used drugs for the fetus. Differences between subgroups were assessed using McNemar's test on paired proportions.

Main outcome measure: Proportion of women exposed to drugs or class of drugs.

The overall drug exposure was higher in pregnancy (34.7 %) than before pregnancy (29.9 %), p>0.05, in the cohort of 311 pregnant women. A significantly greater prescription drug use, 19.0 versus 27.3 % of women, p<0.05, and less selfmedication with over the counter drugs in pregnancy, 15.1 versus 8.7 %, p<0.05, were observed. Commonly used drugs were musculoskeletal drugs, analgesics/antipyretics and respiratory system drugs before pregnancy (13.8, 12.5, and 6.4 % of women, respectively), and progestogens, analgesics/ antipyretics, and antibiotics for the systemic use in pregnancy (9.0, 7.7, and 7.4 %, respectively). A greater exposure to drugs belonging to the FDA risk category A (3.9 vs. 60.8 %, p<0.05), B (18.0 vs. 19.6 %, p>0.05), C (10.0 vs. 10.3 %, p>0.05) and D (2.9 vs. 10.9 %, p<0.05), as well as less exposure to drugs belonging to category X (0.3 vs. 0 %, p>0.05) were observed in pregnancy. Folic acid was used by 60.8 % of women in pregnancy, and by only 3.9 % before pregnancy.

Conclusion: Besides higher overall drug use in pregnancy than before pregnancy, particularly the use of progestogens, and, subsequently, D category drugs, less selfmedication with over the counter drugs was observed in pregnancy. Insufficient use of folic acid before pregnancy requires public health service activities.
Keyword Drug use
FDA pregnancy risk classification
OTC medication
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Pharmacy Publications
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Citation counts: TR Web of Science Citation Count  Cited 6 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
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