Drug Exposure during the Periconceptional Period A Study of 1793 Women

Abstract Background: Many studies have described the prescribing of drugs to pregnant women, but only very few have data concerning the periconceptional period specifically. Aim: The aim of the study was to evaluate the incidence of exposure to teratogenic drugs during early pregnancy and to determine whether a safer drug exists. Methods: In a French health insurances database, we analyzed drugs prescribed during the period starting 1 month before and ending 2 months after the beginning of pregnancy between 1 January 2006 and 31 December 2007. Based on the Summary of Product Characteristics (SPC), drugs we considered were those ‘contraindicated’, ‘not recommended’, ‘to be avoided’, and ‘possible ’ for use during the first trimester of pregnancy. For drugs ‘contraindicated’, we established if there were alternatives with similar efficacy for the mother and lower risk for the fetus. Results:Over a period of 2.25 years, 8754 drugswere prescribed to 1793women starting 1month prior to and ending 2 months after conception. Among these drugs, 20 (0.2%) were ‘contraindicated’, 195 (2.2%) were ‘not recommended’, and 1209 (13.8%) were ‘to be avoided ’ during the first trimester of pregnancy. Twenty (1.1%) women received at least one drug that was ‘contraindicated ’ during the first trimester, 171 (9.5%) received a drug that was ‘not recommended ’ and 768 (42.8%) received a drug that was ‘to be avoided’