In a recent study published in MCN, The American Journal of Maternal/Child Nursing, researchers sought to investigate OTC pain medication use in pregnancy.

This secondary analysis of a weighted surveillance survey utilized the 2019 Iowa Pregnancy Risk Assessment Monitoring System data. For this study, a sample of 759 pregnant women of childbearing age from Iowa was weighted to represent 31,728 Iowan mothers.

The weighted sample was comprised of 80% non-Hispanic white mothers, with smaller percentages of Hispanic (10%) mothers and non-Hispanic black (7%) mothers, which aligned with the overall population of Iowa. An estimated two-thirds of women had commercial insurance (66%), some college or greater education (62%), and were from urban areas (59%).

The authors wrote, “To assess the use of OTC medication during pregnancy, the following items were included in the 2019 survey as a supplement: Prescription Opioid Use. Respondents were asked whether (yes or no) they consumed each of the four OTC pain relievers (acetaminophen, ibuprofen, aspirin, and naproxen). They were considered to have taken OTC pain relievers during pregnancy if they indicated ‘yes’ to acetaminophen, ibuprofen, aspirin, and naproxen. They were considered to have taken non-recommended OTC pain relievers that could cause harm to the fetus if she indicated ‘yes’ to ibuprofen, aspirin, or naproxen.”

For this analysis, descriptive statistics were computed, and variables included the usage of OTC pain relievers among all respondents. Data were further compiled by race/ethnicity and education level.

The results revealed that 76% of women reported taking OTC pain relievers during pregnancy. Of this percentage, 71% of women reported taking acetaminophen, 11% reported taking ibuprofen, 8% reported taking aspirin, and 3% reported taking naproxen. Additionally, an estimated 80% of non-Hispanic white mothers reported taking an OTC pain reliever during pregnancy compared with just 64% of mothers reported as Hispanic. The percentage of OTC analgesic use among women with a college education or greater and those with a high school education or less was reported as 84% and 64%, respectively.

Based on their findings, the authors wrote, “Our results indicate that approximately three-fourths of pregnant women used an OTC pain medication at least once during pregnancy. Our findings of demographic profiles of OTC use align with results of prior studies that found higher use among non-Hispanic White women, those with higher levels of education, those with higher socioeconomic status as well as low use among Hispanic women.”

Moreover, the authors concluded, “Some medications may cause harm to the fetus if taken at specific time during pregnancy. Reinforcement of current pain medication education, including risks to the fetus throughout pregnancy, may be needed.”

Finally, the authors recommended that nurses, midwives, and nurse practitioners educate women about the use of OTC pain medication before pregnancy and at crucial times during pregnancy, including during the first trimester, 20 weeks’ gestation, and again at the start of the third trimester to diminish potential adverse effects. Additionally, evaluation of OTC analgesic use during pregnancy is warranted at every prenatal care visit.

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