PATTERN AND SAFETY OF DRUG PRESCRIPTIONS AMONG ANTENATAL WOMEN IN NIGERIA

INTRODUCTION:  Drug use in pregnancy is always a concern owing to the potential risk(s), both to the mother and to the foetus. Thus pregnant women are advised to consult their doctor or pharmacist before taking any drug, including over the counter medicines. The study aimed at evaluating the pattern and safety of drug prescriptions at antenatal clinics. 

METHODS: The study involved retrospective assessment of patients’ antenatal folders selected from two public hospitals in Enugu State, Nigeria. Relevant information was extracted using a proforma.

RESULTS:  The average number of drugs per prescription was 4.97. Among the 815 women whose folders were analysed, 270 (33.1%) had at least one of the FDA category C, D or X drug prescribed during pregnancy. The exposure rate was higher for category C drugs (31.5%) than for category D (6.7%) or X (0.1%) drugs. Antenatal routine drugs, comprising of multivitamins and iron, were prescribed for all women. The second most prescribed drug group was antimalarials (82.8%), followed by analgesics (25.6%). Total number of drugs prescribed per woman [aOR= 38.37, 95% CI = 14.84-99.21], prescription of an analgesics [aOR =79.44, 95% CI = 13.21- 481.07] or an antibiotics [aOR = 0.03, 95%CI = 0.01 – 0.18] were significantly associated with the chance of women receiving at least a drug from category C, D or X. 

CONCLUSIONS: Exposure to drugs with recognized potential pregnancy risk was high - occurring in at least 3 out of every 10 pregnant women in this urban area. However, prescription of antenatal routine drugs, which included folic acid and haematinic supplements, was very commendable. These findings emphasized the need for regular prescription audit and continuing education for physicians in order to promote rational and safer drug prescribing in pregnancy.