Programme no. 343-OP
Public Health
Drug use six months prior, during early pregnancy and 1-2 years postpartum. Cohort study from the Childbirth and Health Study in Primary Care.
Thury Osk Axelsdottir*1, Hildur Kristjansdottir2, Johann A. Sigurdsson3, Emil L. Sigurdsson4
1Department of Family Medicine, Solvangur Health Centre,University of Iceland,220 Hafnarfjörður,Iceland, 2Department of Midwifery,University of Iceland,Reykjavik,Iceland;Directorate of Health,Reykjavik,Iceland, 3General Practice Research Unit,Primary Health Care of the Capital Area,Reykjavik,Iceland;General Practice Research Unit,Department of Public Health and General Practice,Norwegian University of Science and Technology (NTNU), Trondheim,Norway, 4Department of Family Medicine,University of Iceland,Reykjavik,Iceland
* = Presenting author
Objectives: The aim of this current study is to describe drug use six months prior to pregnancy, during 11-16 weeks of pregnancy (phase I) and 12-21 months postpartum (phase III).
Background: The Childbirth and Health (C&H) study, in Iceland 2009, showed that self-reported drug use during early pregnancy was reduced by 18% compared to six months prior.
Results: Most of the women, 66%, are 25-34 years old, 93% were married or cohabiting, 62% had higher/university education and 69% lived in the capital area. In phase III, response rates had dropped to 657 women or 59% and 69% had higher/university education. The cohort was representative for Iceland’s birth cohort but a trend towards higher education level was seen.

Drug use from all categories was 92%:89% in phase I: phase III. Vitamins/minerals were used by 88%:76% in phase I: phase III, thereof 65%:41% on a daily basis. With the exclusion of vitamins/minerals/homeopathic medicine, 77% of women use drugs six months prior to pregnancy, 49%: 53% in phase I: phase III. Analgesic use is most common; 63% six months prior to pregnancy, 46%: 58% phase I: phase III. Psychotropic use was 12% prior to pregnancy, 6%: 11% phase I: phase III.

Material/Methods: In phase I of C&H, a total of 1111 women participated by filling out a postal questionnaire concerning social situation, birth history and drug use, both current and six months prior. A follow-up questionnaire was filled in at phase III. Drug categories screened for in phase I and III, were psychotropics (antidepressants, relaxants and sleep medication), analgesics, hormones, nicotine, vitamins/minerals and homeopathic medicine. In phase I and III, replies regarding drug use were categorized into seldom, every week and daily.
Conclusion: Overall drug use is increased during early pregnancy, due to increase in vitamin/mineral use. With the exclusion of vitamins/minerals/homeopathic medicine, a reduction in drug use is seen during early pregnancy and an expected increase postpartum. This is in accordance to previous studies that have shown that women reduce prescribed drug use during pregnancy. However, postpartum drug use is significantly lower than six months prior to pregnancy. This could be explained by lower response rates in phase III.
Points for discussion: 1) Drug use before, during pregnancy and postpartum.

2) Clinical implications.