Key Findings: Safe Lists for Medications in Pregnancy: Inadequate Evidence Base and Inconsistent Guidance from Web-based Information, 2011

The journal Pharmacoepidemiology and Drug Safety has published a new brief report: “Safe Lists for Medications in Pregnancy: Inadequate Evidence Base and Inconsistent Guidance from Web-based Information, 2011.” You can read the article’s abstract here. See below for a summary of the findings from this article.

Main Findings from This Study:

Numerous internet websites post lists of medicines that are safe to take during pregnancy. However, these lists are based on limited evidence and provide inconsistent guidance for women.  Half of the websites examined were missing a key message encouraging women to talk to their health care provider about using medicine during pregnancy.

About this Study:

• What is currently known on this subject?
  Using medicine during pregnancy is fairly common. In fact, over 90% of women use at least one medicine during pregnancy, and about 70% use at least one prescription medicine¹. However, most of the medicines, about 98%, that were approved for use in the United States between 2000 and 2010 had limited data to assess the risk for birth defects².

  In addition, previous research has shown that about 50% of women of reproductive age look for health information on the internet³. Thus, women are more and more often getting information on health care from sources other than their physicians.

• What were the study results?
  This brief study looked for information on the internet about using medicine during pregnancy.  Researchers found 25 active internet websites that list medicines reported to be safe for use in pregnancy. Researchers looked at these listed medicines and tried to find out if there was scientific evidence to support this guidance.

  On these internet websites, 245 medicine products were listed as safe for use during pregnancy. In this study, researchers reviewed ingredients of these products to verify safety claims. For example, acetaminophen might be an ingredient in a cold medicine or a pain relief product. A large proportion of these medicine ingredients, about 40%, lack data to support safety claims for use during pregnancy. Women who see a medicine product on one of these “safe lists” are likely to assume that there is no increased risk of birth defects if they take the medicine during pregnancy. As a result, women are being reassured that taking these medicines is safe during pregnancy even though sufficient evidence to determine the safety or risk does not exist. Further, many of these websites do not encourage women to seek information and guidance from their health care providers.

• What does this mean?
  Pregnant women should not stop or start taking any type of medicine that they need without first talking with a doctor. Women who are planning to become pregnant should discuss the need for any medicine with their doctor before becoming pregnant and ensure they are taking only medicines that are necessary.

Medication during pregnancy: CDC’s Activities

CDC is committed to working with its partners and the public to build a comprehensive approach to understanding and communicating the risks of birth defects that potentially are associated with the use of medications during pregnancy.

• Research: CDC funds a large study of birth defects called the National Birth Defects Prevention Study. This study is working to identify risk factors for birth defects and to answer questions about some medications taken during pregnancy.
• Technical expertise: CDC works with staff from the U.S. Food and Drug Administration and other professionals to help conduct studies on the effects of medication use during pregnancy and ways to prevent harmful effects.

To learn more about medication use during pregnancy, please visit www.cdc.gov/pregnancymedication.

References:

1. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol 2011;205:51.e1-51.e8.
2. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet Part C Semin Med Genet 2011;157:175-82.
3. Petersen EE, Rasmussen SA, Daniel KL, Yazdy MM, Honein MA. Prescription medication borrowing and sharing among women of reproductive age. J Womens Health (Larchmt) 2008;17(7):1073-80.

Reference for Key Findings Feature:

Peters SL, Lind JN, Humphrey JR, et al. Safe Lists for Medications in Pregnancy: Inadequate Evidence Base and Inconsistent Guidance from Web-based Information, 2011. Pharmacoepidemiol Drug Saf. 2013 [epub ahead of print].