Norwich, UK—Pregnant women often choose not to medicate routine pregnancy symptoms because they overestimate the risks of taking OTC and prescribed medication, according to a new British study.

Not taking drugs for nausea, heartburn, and body aches is one thing, according to researchers from the University of East Anglia, but that overabundance of caution also extends to conditions such as urinary tract infections (UTIs), which can cause significant complications and harm the unborn child if left untreated. The report was published in the International Journal of Clinical Pharmacy.

Lead researcher Michael Twigg, MPharm, from UEA’s School of Pharmacy, said the study team “wanted to know how these beliefs and fears relate to actual medication taking—whether they stop women taking medication which is actually safe.”

The international research team used popular websites such as Bounty and the Pregnancy Forum to find 1,120 volunteers for an online survey. Participants were asked which common conditions they had experienced during pregnancy, e.g., nausea, heartburn, constipation, colds, UTIs, neck and pelvic pains, headaches, and sleeping problems.

In addition to being questioned about how harmful or beneficial they believed medications to be, the women were asked if they deliberately avoided any pharmaceuticals during pregnancy, and if so which ones. Participants also rated drugs, food and other substances on a scale of 0 to 10 based on their beliefs about harm.

“We found that just over three quarters of the women used some form of medication to treat at least one common condition experienced during pregnancy,” Twigg said in a University of East Anglia press release. “Relatively few took medication for nausea, constipation or sleeping problems. However these symptoms can be alleviated by changes to diet and lifestyle. We also found that a large number of women thought that taking paracetamol (generally marketed as acetaminophen in the United States) during pregnancy was risky and would avoid it. It is however perfectly safe.”

Study authors say they were more concerned about some conditions than others.

"One of the most worrying things we discovered was that many women who experienced a UTI did not take medication for it. If left untreated, UTIs can cause significant complications and harm the fetus,” Twigg pointed out. “A total of 72% of the women said they deliberately avoided using certain medicines during pregnancy—particularly paracetamol, ibuprofen, cough and cold remedies, antihistamines, and nasal decongestants—for fear of harming their unborn child.”

Why did the expectant mothers refuse to treat symptoms? “Overall, women who did not take medication perceived the risk to be greater than those who chose to take medication,” he said.

Pharmacologic treatment of conditions in pregnancy ranged from 65.4% for UTIs to 1.1 % for sleeping problems, according to the results.

Women who did not treat heartburn and UTIs viewed medicines in general as being overused, more harmful and less beneficial, than those who treated the conditions.

“Women’s beliefs about medications impact on treatment of specific conditions in pregnancy such as heartburn and UTIs,” study authors conclude. “Healthcare professionals should explore patient’s beliefs regarding medication at the first maternity care visit to promote appropriate medication use in pregnancy.”

That is especially the case for pharmacists, according to Twigg. While about half the women said they used the Internet for information, “Many also said they seek advice from pharmacists so it would be beneficial for pharmacists to have better professional training in this area.”

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