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Prevalence of polypharmacy in pregnancy : a systematic review

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Date
07/03/2023
Author
Anand, Astha
Phillips, Katherine
Subramanian, Anuradhaa
Lee, Siang Ing
Wang, Zhaonan
McCowan, Rebecca
Agrawal, Utkarsh
Fagbamigbe, Adeniyi
Nelson-Piercy, Catherine
Brocklehurst, Peter
Azcoaga-Lorenzo, Amaya
Damase-Michel, Christine
Loane, Maria
Nirantharakumar, Krishnarajah
Azcoaga-Lorenzo, Amaya
MuM-PreDiCT Group
Keywords
RG Gynecology and obstetrics
RM Therapeutics. Pharmacology
MCC
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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. PROSPERO registration number CRD42021223966.
Citation
Anand , A , Phillips , K , Subramanian , A , Lee , S I , Wang , Z , McCowan , R , Agrawal , U , Fagbamigbe , A , Nelson-Piercy , C , Brocklehurst , P , Azcoaga-Lorenzo , A , Damase-Michel , C , Loane , M , Nirantharakumar , K , Azcoaga-Lorenzo , A & MuM-PreDiCT Group 2023 , ' Prevalence of polypharmacy in pregnancy : a systematic review ' , BMJ Open , vol. 13 , no. 3 , e067585 . https://doi.org/10.1136/bmjopen-2022-067585
Publication
BMJ Open
Status
Peer reviewed
DOI
https://doi.org/10.1136/bmjopen-2022-067585
ISSN
2044-6055
Type
Journal item
Rights
Copyright © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY.
Description
Funding: 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.
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/27141

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