Potentially harmful medication use and the associated factors among pregnant women visiting antenatal care clinics in Mbarara Regional Referral Hospital, Southwestern Uganda

John Isiiko; Joshua Kiptoo; Tadele Mekuriya Yadesa; Daniel Chans Mwandah; Rachel Alinaiswe; Joseph Ngonzi; Paul E Alele

Potentially harmful medication use and the associated factors among pregnant women visiting antenatal care clinics in Mbarara Regional Referral Hospital, Southwestern Uganda

J Clin Transl Res. 2022 Dec 28;9(1):16-25. eCollection 2023 Feb 25.

Authors

John Isiiko^{1

2}, Joshua Kiptoo¹, Tadele Mekuriya Yadesa^{1

3}, Daniel Chans Mwandah⁴, Rachel Alinaiswe¹, Joseph Ngonzi⁵, Paul E Alele⁴

Affiliations

¹ Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda.
² Department of Pharmacy, Uganda Cancer Institute, Mbarara, Uganda.
³ Department of Pharmacy, Ambo University, Ambo, Ethiopia.
⁴ Department of Pharmacology, Mbarara University of Science and Technology, Mbarara, Uganda.
⁵ Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.

PMID: 36687297
PMCID: PMC9844225

Abstract

Background: Pregnancy management using medications has been challenging for both healthcare providers and pregnant women, given the fear of teratogenicity effects and the potential for fetal harm. In the developing world, poor health-seeking behavior of patients, delayed initiation of antenatal care (ANC), and low level of educational status of mothers could contribute to the issue of drug safety in pregnancy.

Aim: The aim of the study was to determine the prevalence and factors associated with potentially harmful medication use in pregnancy.

Methods: A cross-sectional study was conducted from April 1 to June 6, 2021, including 209 pregnant women on ANC follow-up at a referral hospital in Southwestern Uganda. The simple random sampling technique was employed to select study participants. Interviewer-administered questionnaires were used to collect the history of medication use since conception and then the participant's ANC card was reviewed to determine prescribed drug regimens and their indications. Statistical Package for the Social Sciences version 23.0 was used for analysis.

Results: Out of the 1,422 medications used by 209 women, 665 (42.2%) were category C, and 182 (11.5%) were category A. A total of 92 (44.0%) pregnant women used at least one potentially harmful medication during the current pregnancy. Having more than average monthly income (adjusted odds ratio [aOR] = 2.32 [1.04, 5.14 at 95% confidence interval (CI)]), having a chronic disease (aOR = 3.24 [1.17, 8.97 at 95% C.I]), using 7 and more medications (aOR = 9.12 [4.11, 20.24 at 95% CI]), and use of herbal medicines (aOR = 4.50 [2.10, 9.87 at 95% CI]) were shown to be risk factors.

Conclusion: The proportion of pregnant women that used at least one potentially harmful medication is higher than in previous studies. Having comorbidities and taking more medications increase the risk of receiving a potentially harmful medication during pregnancy.

Relevance to patients: This study identified the gaps in the use of medicines during pregnancy which will enable the development and implementation of protocols for optimizing prescribing practices in pregnant women by focusing on the safety of the fetus.

Keywords: Antenatal care; Drug use; Herbal; Non-prescription; Pregnancy; Uganda.