Prevalence of polypharmacy in pregnancy: a systematic review

Astha ANAND, Katherine Phillips, Anuradhaa SUBRAMANIAN, Siang Ing LEE, Rebecca McCowan, Utkarsh AGRAWAL, Adeniyi Francis Fagbamigbe, Catherine Nelson-Piercy , Peter Brocklehurst, Christine Damase-Michel, Maria Loane, Krishnarajah NIRANTHARAKUMAR, Amaya Azcoaga-Lorenzo

Research output: Contribution to journalArticlepeer-review

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Abstract

Objectives: The use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes. Design: MEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included. Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed. Results: Fourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy. Conclusion: There is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms. Tweetable abstract: Our systematic review shows significant burden of polypharmacy in pregnancy but outcomes for women and offspring are unknown. PROSPERO registration number: CRD42021223966.
Original languageEnglish
Article number067585
Pages (from-to)1-11
Number of pages12
JournalBMJ Open
Volume13
Issue number3
Early online date6 Mar 2023
DOIs
Publication statusPublished online - 6 Mar 2023

Bibliographical note

Funding Information:
This work was funded by the Strategic Priority Fund 'Tackling multimorbidity at scale' programme (grant number MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

Keywords

  • 1506
  • EPIDEMIOLOGY
  • Maternal medicine
  • OBSTETRICS
  • Obstetrics and gynaecology
  • MEDLINE
  • Prevalence
  • Humans
  • Male
  • Multimorbidity
  • Pregnancy
  • Polypharmacy
  • Family
  • Female

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