Predictors of medication use during pregnancy: A cohort study

Abstract

Background: Sociodemographic characteristics and health behaviours are associated with medication use in pregnancy, but it is unclear if they are independent predictors because women´s health status has hardly been accounted for. We aimed to identify predictors of use of medications and of iron/folic acid. Methods: This cohort included pregnant women recruited in a prenatal clinic in Trieste, Italy, from 2007 to 2009. Dispensations were obtained from the regional outpatient dispensation database through record linkage. We calculated the Odds Ratio (OR), with 95% confidence interval (95%CI), of ≥ 1 dispensation of (a) any medication and (b) iron/folic acid, using unconditional logistic regression. The final model adjusted for age, partner education, housing size, comorbidities. Findings: Of 767 women, 70.5% had ≥ 1 dispensation of any medication and 46.1% of iron/folic acid. Use of any medication was predicted by immigrant status of the woman (OR 1.21; 95%CI 0.57–2.53) or of her partner (1.51; 0.67–3.40), ≤ high school degree of the woman (1.11; 0.61–2.03) or of her partner (1.21; 0.75–1.95), unemployment (1.47; 0.72–2.98), smoking (1.25; 0.65–2.40), alcohol consumption (≥5 drinks/week: 2.78; 1.78–4.34), and obesity (1.33; 0.59–2.99). Use of iron and/or folic acid was predicted by ≤ high school degree (0.65; 0.40–1.08), smoking (0.80: 0.47–1.37), and obesity (0.62; 0.31–1.25). Conclusion: In this cohort, characteristics including education, immigrant and employment status, smoking, alcohol consumption, and obesity independently predicted medication use. Interventions to promote safe use of medications should carefully consider women´s characteristics.