Læknablaðið - jan. 2019, Blaðsíða 16

16 LÆKNAblaðið 2019/105
R A N N S Ó K N
1. Bakker MK, Jentink J, Vroom F, Van Den Bert PB, De Walle
HE, De Jong-Van Den Berg D. Drug prescription patterns
before, during and after pregnancy for chronic, occasional
and pregnancy-related drugs in the Netherlands. BJOG
2006; 113: 559-68.
2. Daw JR, Hanley GE, Greyson DL, Morgan SG.
Prescription drug use during pregnancy in developed
countries: a systematic review. Pharmacoepidemiol Drug
Saf 2011; 20: 895-902.
3. Gagne JJ, Maio V, Berghella V, Louis DZ, Gonnella JS.
Prescription drug use during pregnancy: a population-
based study in Regione Emilia-Romagna, Italy. Eur J Clin
Pharmacol 2008; 64: 1125.
4. Chambers C. Over-the-counter medications: Risk and
safety in pregnancy. Sem Perinatol 2015; 39: 541-4.
5. Adam MP, Polifka JE, Friedman JM. Evolving knowledge
of the teratogenicity of medications in human pregnancy.
Am J Med Genet C Sem Med Genet 2011; 157: 175-82.
6. Nordeng H, Ystrøm E, Einarson A. Perception of risk
regarding the use of medications and other exposures
during pregnancy. Eur J Clin Pharmacol 2010; 66: 207-14.
7. Hämeen-Anttila K, Jyrkkä J, Enlund H, Nordeng H,
Lupattelli A, Kokki E. Medicines information needs
during pregnancy: a multinational comparison. BMJ Open
2013;3(4).
8. Zaki NM, Albarraq AA. Use, attitudes and knowledge
of medications among pregnant women: A Saudi study.
Saudi Pharmaceut J 2014; 22: 419-28.
9. Nordeng H, Koren G, Einarson A. Pregnant Women’s
Beliefs About Medications - A Study Among 866
Norwegian Women. Ann Pharmaco 2010; 44: 1478-84.
10. Phatak HM. Relationships Between Beliefs about
Medications and Nonadherence to Prescribed Chronic
Medications. Ann Pharmaco 2006; 40: 1737-42.
11. Bánhidy F, Lowry RB, Czeizel AE. Risk and Benefit of
Drug Use During Pregnancy. Int J Med Sci 2005; 2: 100-6.
12. Hancock RL, Koren G, Einarson A, Ungar WJ. The effect-
iveness of Teratology Information Services (TIS). Reprod
Toxicol 2007; 23: 125-32.
13. Aronsson CA, Vehik K, Yang J, Uusitalo U, Hay K,
Joslowski G. Use of dietary supplements in pregnant
women in relation to sociodemographic factors – a report
from The Environmental Determinants of Diabetes in
the Young (TEDDY) study. Publ Health Nutr 2013; 16:
1390-402.
14. Headley J, Northstone K, Simmons H, Golding J, ALSPAC
Study Team. Medication use during pregnancy: data from
the Avon Longitudinal Study of Parents and Children. Eur
J Clin Pharmacol 2004; 60: 355-61.
15. Sato Y, Nakanishi T, Chiba T, Yokotani K, Ishinaga K,
Takimoto H, et al. Prevalence of Inappropriate Dietary
Supplement Use Among Pregnant Women in Japan. Asia
Pacif J Clin Nutr 2013; 22: 83-9.
16. Kennedy DA, Lupattelli A, Koren G, Nordeng H. Safety
classification of herbal medicines used in pregnancy in
a multinational study. BMC Complement Altern Med
2016; 16.
17. Orief YI, Farghaly NF, Ibrahim MIA. Use of herbal med-
icines among pregnant women attending family health
centers in Alexandria. Middle East Fert Soc J 2014; 19:
42-50.
18. Hall HG, Griffiths DL, McKenna LG. The use of complem-
entary and alternative medicine by pregnant women: A
literature review. Midwifery 2011; 27: 817-24.
19. Holst L, Wright D, Haavik S, Nordeng H. The use and
the user of herbal remedies during pregnancy. J Altern
Complement Med 2009; 15: 787-92.
20. Nordeng H, Havnen GC. Impact of socio-demographic
factors, knowledge and attitude on the use of herbal drugs
in pregnancy. Acta Obstet Gynecol Scand 2005; 84: 26-33.
21. Pallivalappila AR, Stewart D, Shetty A, Pande B, McLay
JS. Complementary and Alternative Medicines Use during
Pregnancy: A Systematic Review of Pregnant Women
and Healthcare Professional Views and Experiences. Evid
Based Complement Alternat Med 2013.
22. fass.se – febrúar 2018.
23. Sinclair SM, Miller RK, Chambers C, Cooper EM.
Medication Safety During Pregnancy: Improving
Evidence-Based Practice. J Midwif Women Health 2016;
6: 52-67.
24. Zoega H, Kieler H, Nørgaard M, Furu K, Valdimarsdottir
U, Brandt L, et al. Use of SSRI and SNRI Antidepressants
during Pregnancy: A Population-Based Study from
Denmark, Iceland, Norway and Sweden. PLoS ONE 2015;
10(12).
25. Baldvinsdóttir D. Notkun þunglyndislyfja á með-
göngu meðal kvenna á Íslandi 2003-2012: Lýðgrunduð
rannsókn á landsvísu (meistaraprófsritgerð, Háskóli
Íslands, Reykjavík). 2016. https://skemman.is/hand-
le/1946/25180?locale=en - ágúst 2018.
26. Guðmundsdóttir Þ. Rannsókn á lyfjanotkun barnshafandi
kvenna á Íslandi. Óútgefin kandídatsritgerð, Háskóli
Íslands, Reykjavík 2001.
27. landlaeknir.is – febrúar 2018.
28. Milunsky A, Jick H, Jick SS, Bruell CL, MacLaughlin DS,
Rothman KJ, et al. Multivitamin/folic acid supplementa-
tion in early pregnancy reduces the prevalence of neural
tube defects. JAMA 1989; 262: 2847-52.
29. De-Regil LM, Peña-Rosas JP, Fernández-Gaxiola AC,
Rayco-Solon P. Effects and safety of periconceptional oral
folate supplementation for preventing birth defects. Cochr
Datab Syst Rev 2015; (12): CD007950.
30. Al Rakaf MS, Kurdi AM, Ammari AN, Al Hashem AM,
Shoukri MM, Garne E, et al. Patterns of folic acid use
in pregnant Saudi women and prevalence of neural
tube defects—Results from a nested case–control study.
Prevent Med Report 2015; 2: 572-6.
31. Hodgetts VA, Morris RK, Francis A, Gardosi J, Ismail KM.
Effectiveness of folic acid supplementation in pregnancy
on reducing the risk of small-for-gestational age neonates:
a population study, systematic review and meta-analysis.
BJOG 2015; 122: 478-90.
32. Schaefer C, Hannemann D, Meister R. Post-marketing
surveillance system for drugs in pregnancy—15 years
experience of ENTIS. Repro Toxicol 2005; 20: 331-43.
Heimildir
Barst til blaðsins 10. ágúst 2018, samþykkt til birtingar 27. nóvember 2018.
Unnur Sverrisdóttir1
Freyja Jónsdóttir1,2
Anna Ingibjörg Gunnarsdóttir1,2
Hildur Harðardóttir3,4
Ragnheiður Ingibjörg Bjarnadóttir4,5
Introduction: Evidence-based information regarding the use
of medication during pregnancy is lacking, even though the use
of medication during pregnancy is considered common and
often neccesary. The aim of this study was to obtain reliable
information on the use of medications during the first 20 weeks
of pregnancy and the use of vitamins, minerals, fatty acids, herbs
and other natural products. Women´s attitude and beliefs towards
the use of medications was also examined.
Material and methods: The study was conducted at the Prenatal
Diagnosis Unit at Landspitali from January to April 2017. Women
who attended routine ultrasound examination at 20 weeks were
offered to participate. A questionnaire was submitted to partici-
pants in an interview with the researcher following the doctor’s
appointment.
Results: Of the 213 participants, 90% used medication at least
once during the first 20 weeks of pregnancy. Approximately 80%
of these medications belong to FASS safety classes A and B and
are considered safe during pregnancy. The proportion of women
who did not use folic acid was 14% which was associated with
residence in rural areas (p=0.03) and younger age (p=0.019).
Natural products were used by 14% but information about
their safety is lacking. The majority (81%) was satisfied with the
information they received when a drug was prescribed and 94%
said they had sufficient access to information about medication
use during pregnancy. The most commonly used sources of
information were the internet (51%) and the local midwive (44%).
Conclusion: The use of medications and supplements during
pregnancy is common. Most medications being used are
considered safe during pregnancy. The majority of pregnant
women take folic acid. Pregnant women have a logical and gener-
ally a positive attitude towards medication use during pregnancy.
Use of medication, supplements and natural products during pregnancy
ENGLISH SUMMARY
1Faculty of Pharmaceutical sciences, The University of Iceland, 2Pharmacy department, The National University Hospital, 3Obstetrics and gynecology, The National
University Hospital, 4Faculty of Medicine, The University of Iceland, 5The Primary health care of the capital area.
Key words: pregnancy, medication, natural product, supplement, attitude, knowledge.
Correspondence: Unnur Sverrisdóttir, unnursve@gmail.com