Drug-prescribing patterns during pregnancy in the tertiary care hospitals of Pakistan: a cross sectional study

Dileep K Rohra¹ , Nirmal Das² , Syed I Azam³ , Nazir A Solangi⁴ , Zahida Memon⁵ , Abdul M Shaikh⁶ and Nusrat H Khan⁷

¹Department of Biological & Biomedical Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan

²Department of Pharmacology & Therapeutics, Bolan Medical College, Quetta, Pakistan

³Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan

⁴Department of Pharmacology & Therapeutics, Nawabshah Medical College, Nawabshah, Pakistan

⁵Department of Pharmacology & Therapeutics, Dow University of Health Sciences, Karachi, Pakistan

⁶Department of Pharmacology & Therapeutics, Chandka Medical College, Larkana, Pakistan

⁷Department of Obstetrics & Gynaecology, Unit III, Dow Medical College and Civil Hospital, Karachi, Pakistan

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BMC Pregnancy and Childbirth 2008, 8:24doi:10.1186/1471-2393-8-24


Published:	15 July 2008

Abstract

Background

The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan.

Methods

This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outpatient medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected. The drugs were classified according to the pharmacological class and their teratogenic potential.

Results

All the pregnant women attending the antenatal clinics received a prescription containing at least one drug. A total of 3769 distinct prescriptions given to different women were collected. Majority of the women who received the prescriptions belonged to third trimester (55.4%) followed by second (33.6%) and first trimester (11.0%). On an average, each prescription contained 1.66 ± 0.14 drugs. The obstetricians at Civil Hospital, Karachi and Chandka Medical College Hospital, Larkana showed a tendency of prescribing lesser number of drugs compared to those in other hospitals. Anti-anemic drugs including iron preparations and vitamin and mineral supplements (79.4%) were the most frequently prescribed drugs followed by analgesics (6.2%) and anti-bacterials (2.2%). 739 women (19.6%) received prescriptions containing drugs other than vitamin or mineral supplements. Only 1275 (21.6%) of all the prescribed drugs (n = 6100) were outside this vitamin/mineral supplement class. Out of these 1275 drugs, 29 (2.3%) drugs were prescribed which are considered to be teratogenic. Misoprostol was the most frequently prescribed (n = 6) among the teratogenic drugs followed by carbimazole (n = 5) and methotrexate (n = 5). Twenty nine pregnant women (0.8% of all the women studied) were prescribed these teratogenic drugs.

Conclusion

Less than one percent of the pregnant women attending tertiary care hospitals in Pakistan are prescribed teratogenic drugs. The prescribing practices of Pakistani physicians are similar to those in western countries.