(099) Patterns of prescription medication use during pregnancy in the United States, 1997–2018

Publication Number: 1094

Background: Prescription medication use in pregnancy changes over time

Objectives: Describe patterns of prescription medication use in pregnancy.

Methods: We used data from 9,755 women who served as controls in two large United States case–control studies from 1998–2011 and 2014–2018.

Results: After excluding vitamin, herbal, mineral, vaccine, Intravenous fluid, and topical products and over the counter medications, the proportion of women that reported taking at least one prescription medication in the first trimester increased over the study years, from 37% to 50%. The corresponding proportions increasing with maternal age and years of education, were highest for white non–Hispanic women (47%) and lowest for Hispanic women (24%). The most common indication for first trimester use of a medication was infections (12–15%). Increases in medication use were observed across the years for nausea/vomiting, depression/anxiety, infertility, thyroid disease, diabetes, and epilepsy. The largest relative increase in use was observed for nausea/vomiting, which increased from 3.8% in 1997–2001 to 14.8% in 2014–2018, driven in large part by ondansetron for which there was no use in 1997–2001 compared to 9.5% in 2014–2018.

Conclusions: Prescription medication use in the first trimester of pregnancy is common and increasing. Many medical conditions require treatments among pregnant women, often involving pharmacotherapy, which necessitates consideration of the risk and safety profiles for both mother and fetus.