US Pharm. 2024;49(9):14.

The CDC estimates that 90% of U.S. women take some type of medication during pregnancy. Seven in 10 pregnant women report using at least one prescription medication. Despite the frequency of use during pregnancy, fewer than 10% of medications approved (from 1980-present) have sufficient safety information to guide treatment decisions, likely because clinical studies often exclude pregnant women due to potential maternal and fetal risks.


Prescription Drug Use: In August 2024, Mansour et al published findings from a study that examined trends in medication use during pregnancy in the U.S. between 2011 and 2020. Information for more than 3 million pregnancies from the MarketScan Commercial Claims and Encounters database (N = 1,754,125; 2011-2020), Medicaid Analytic eXtract/Transformed Medicaid Statistical Information System Analytic Files (MAX/TAF; N = 1,475,321; 2011-2018), and National Health and Nutrition Examination Survey (NHANES; N = 279; 2011-2020) was analyzed. Overall, the most dispensed medications during pregnancy were antibiotics, analgesics, and antiemetics. The dispensing of antibiotics and antiemetics remained stable throughout the study period; however, analgesic dispensing decreased from 20.6% to 16.7% in MarketScan and 29.9% to 23.6% in MAX/TAF, primarily due to reductions in the number of prescriptions for acetaminophen and opioid combination products.

Drug Overdoses: According to an analysis of data from the National Vital Statistics mortality files (Bruzelius and Martins, 2022), pregnancy-associated drug overdose mortality has steadily increased over time. The most pronounced increase (81%; 6.56-11.85 per 100,000) was reported between 2017 and 2020. During this period, deaths related to benzodiazepines, prescription opioids, and heroin among pregnant and postpartum women remained stable, whereas deaths involving fentanyl (and other synthetics) and psychostimulants (e.g., methamphetamine, cocaine) increased. A significant increase in drug overdose deaths involving fentanyl and other synthetics was seen (5.73-9.47 per 100,000). Clinicians need to regularly perform comprehensive assessments of all medications and substances for their pregnant and postpartum patients.

Resources: Many online databases containing information on medications and other substances are available to the public. The FDA website lists safety information for specific medications and risks for pregnant and breastfeeding women. MotherToBaby, a service of the Organization of Teratology Information Specialists, is a no-cost online resource that provides evidence-based information on the benefits and risks of various products during pregnancy and breastfeeding. The LactRx app, which was developed by MotherToBaby, gives breastfeeding mothers free access to information from the National Library of Medicine’s LactMed database on medications, vaccines, diagnostic agents, and other substances. Even when using these resources, women who are pregnant or plan to become pregnant or breastfeed should discuss any medication use with their healthcare provider before initiation.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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