| Description |
Despite the large number of women who become pregnant and use a medication during their pregnancy, there is very little information about the safety of the majority of medications. Most drugs approved by the FDA have undetermined teratogenic risk, but their use is prevalent in the management of disease during pregnancy. Physicians are faced with the daunting challenge of prescribing a dose that will have the intended therapeutic effect without putting the mother and fetus at risk, should they choose to prescribe at all. Section 1 describes trends and practices of medication use among pregnant women. As many as 90% of pregnant women take at least one medication during their pregnancy to manage other morbidities. Research into perinatal medicine has been extremely neglected and the majority of FDA drug classifications for pregnant women conclude that there is insufficient information and human data to make any conclusive statement about the drug's safety. It is an extremely precarious challenge to prescribe a dose that is neither so low that it is ineffective or so high that it is toxic and harmful. Often, a doctor or pharmacist will simply recommend stopping the medication during pregnancy, if possible. In other instances, continued use of the medication during pregnancy is inevitable, despite the risks. Section 2 is a literature review that examines the prevalence of common morbidities during pregnancy and common medications used as treatments, the respective drug's FDA pregnancy ranking, and consequences to the mother and fetus if the disease is left untreated. An average of 11.87% (± 1.83%) of pregnant women have at least one iii of the examined conditions, and an average of 82.75% (± 17.0%) of each disease's treatment options have unknown risk. The most common consequences of untreated disease in the mother are worsening of symptoms, preeclampsia, and risk of future disease, while those in the fetus are premature birth, miscarriage, and low birth weight. The results illustrate the need for both established treatment options during pregnancy as well as further research into this vulnerable population. Section 3 is a retrospective chart review of pregnant cystic fibrosis patients at the University of Utah Hospital. The goal of the review is to understand what antibiotics pharmacists are prescribing and in what dosages in order to illuminate any prescribing patterns despite the lack of guidelines. Data collected includes demographics, antibiotic information, and pulmonary function as a measure of health. The University of Utah Hospital's database contained records for 32 patients for a total of 44 pregnancies. Analysis showed that most pregnancies showed up to a 199% higher usage of antibiotics outside of pregnancy, though some patients' usage was over 1000% greater. An average of 5.63 (± 5.93) antibiotic dosages were prescribed for use during pregnancy, and 50% of those drugs were prescribed for use the day the pregnancy ended. These elucidated trends point to areas of future research to understand the informal guidelines or physician discretion behind them. |
