1.

Background
Pregnancy is a period from conception to birth. It is a physiological and normal process that
happens in a woman. Several physiological changes occur in pregnancy to provide requirement
changes for the developing fetus and prepare the mother for labor and delivery. Some of the
changes may mimic symptoms of medical disease while others can impact normal biochemical
values. Thus pregnant women may experience symptoms of nausea with or without vomiting,
increased urination, constipation, back pain, subjective feeling of breathlessness and edema on
lower extremities.1 By the presence of the mentioned symptoms, pregnant women tend to seek
for medication, especially drugs. Drug shouldn’t be used during pregnancy unless absolutely
necessary for the fact that it can reach the fetus and harm it by crossing the placenta, the way
how nutrients and oxygen reach the fetus to nurture fetus’ growth and development.2

Some women may have a condition that require episodic treatment, for example asthma,
hypertension and epilepsy. During pregnancy, new medical problem may arise and present ones
can be exarcebated requiring pharmacological therapy. Organogenesis occur in the first trimester
of pregnancy, thus drug use during this period can interfere and causing congenital defect. 2
During second and third pregnancy, drugs can influence growth and development of the fetus
and can cause placental poisoning.3

It has been reported that approximately 8% of pregnant women need pharmacological treatment
due to various medical problems and pregnancy related complication. 4 A recent study in Ethiopia
on 2013 found that 55.2% of all pregnant women consumed at least one prescribed drug. The
most frequent drug to be consumed are antibiotics (42.5%) and analgetics (40.1%). 7-17% of
pregnant women has been reported consuming drugs of unsafe category (D and X).5

A study conducted in Europe, Australia and America reported that approximately 80% of
pregnant women had consumed at least one type of drug during their pregnancy. 6 Older
unemployed (housewive) pregnant women with low educational level and unplanned pregnancy
had been reported as the most group with the most frequent usage of drug for chronic diseases. 6
The highest prevalence of drug usage during pregnancy has been found in Holland (95.1%),
Iceland (93%) and Finland (92.3%).6

A study held in Bangladesh on 2016 mentioned that from the total of 650 pregnant women,
100% had consumed drug/supplement during pregnancy. A proportion of 12.2% had taken
drug/supplement without doctor’s prescription. The most frequently used drug were antacid
(27.8%), non-steroid antiinflamation drugs (NSAID) (26.6%), vitamins and iron supplementation
(15.2%). The things that supported pregnant women to do self-medication were the availability
of the drugs (42%), based on experience (20.8%), emergency (11.2%), knowledge about the drug
(10%), traditional healer’s suggestion (8%), the present sign and symptoms were not severe
(5.1%) and distrust of doctors (2.9%).4

By far, several studies has been done to see the prevalence of drug usage by pregnant women in
the world.2,4-6
1. Priya Soma-Pillay CN-P, Heli Tolppanen, Alexandre Mebazaa. Physiological Changes in
Pregnancy. Cardiovascular Journal of Africa. 2016;27(2):5.
2. Punam Sachdeva BGP, B. K. Patel. Drug Use in Pregnancy; a Point to Ponder! Indian
Journal of Pharmaceutical Sciences. 2009;71(1):7.
3. RI D. Pedoman Pelayanan Farmasi Untuk Ibu Hamil dan Menyusui. 2006.
4. Sharma R KB, Verma U. Drug Utilization Pattern During Pregnancy in North India. Indian
journal of medical science. 2006;60(7):10.
5. Hanafy S.A SSA, Kharboush I.F, Wahdan I.H. Drug Utilization Pattern During Pregnancy in
Alexandria, Egypt. European journal of pharmaceutical and medical research.
2016;3(2):10.
6. CDC. Medications and Pregnancy. 2011:
http://www.cdc.gov/pregnancy/meds/index.html.