Prescription drug use during and immediately before pregnancy in Hawaii – Data from the Hawaii Pregnancy Risk Assessment Monitoring System, 2009-2010

Background: Although many medications have documented teratogenic effects, there are relatively little population-based data on perinatal prescription drug use. Methods: Hawaii Pregnancy Risk Assessment Monitoring System (PRAMS) data from 3180 respondents were used to estimate prevalence of overall prescription drug use during and in the month before pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawaii in 2009 and 2010. Vitamins and supplements were excluded from the analysis. Results: Of recently-pregnant women in Hawaii, 18.3% (95%CI: 16.6-20.1) reported using prescription drugs during their most recent pregnancy; 14.5% reported prescription use immediately before pregnancy (95%CI: 13.0-16.1). The most commonly-reported medication types taken during pregnancy were anti-infectives (4.2%; 95%CI: 3.4-5.1), asthma/allergy (3.4%; 95%CI: 2.7-4.3), gastrointestinal (3.3%; 95%CI: 2.5-4.2) and pain relievers (3.2%; 95%CI: 2.5-4.2). Pain relievers (2.8%; 95%CI: 2.2-3.7), asthma/allergy (2.8%; 95%CI: 2.2-3.6), anti-infectives (2.3%; 95%CI: 1.7-3.1) and psychiatric medications (2.2%; 95%CI: 1.6-2.9) were most common before pregnancy. Of women reporting prescription use during pregnancy, 10.0% reported that their healthcare provider had not counseled them during prenatal care on which medicines are safe to use during pregnancy (95%CI: 7.3-13.5). Public Health Implications: As prescription drug use among the general public becomes more widespread, there is an increased need for careful monitoring by health care providers of usage in pregnant and reproductive-aged women. Counseling on potential risks to mother and fetus should be emphasized during prenatal care visits to assure that women are informed and empowered to make the best decisions for themselves and their babies.