Study of analgesics usage in third trimester of pregnancy and its ill effects on pregnancy course and outcome
Keywords:Analgesics, Pregnancy third trimester
Background: Pregnancy is a special physiological state. Pregnancy care is one of the greatest challenges in medicine as it demands a special care in the use of drugs because of altered physiology. At least 10 percent of birth defects are thought to result from maternal drug exposures. NSAIDS are one of the most commonly used medications during pregnancy (17%) to treat painful events during pregnancy.
Methods: A prospective observational study was conducted after taking approval from the Institutional ethical committee and study was conducted for a period of one year. Antenatal clinics and inpatients wards of department of obstetrics and Gynaecology were visited and all the pregnant women with exposure to analgesics during third trimester and at the time of labour were included in the study. Information regarding the analgesics exposure either prescribed by the physician or self-medicated was collected.
Results: Total 1520 pregnant women were included in the study over a period of one year. Analgesic exposure was seen in 77.1% of pregnant women during labour. Most common analgesic used to relieve labour pain was tramadol. 22.9% pregnant women were exposed to analgesics during third trimester, among them exposure to paracetamol was observed in 14% of pregnant women and to tramadol in 8.9%. Indications for usage of these analgesics during pregnancy were fever with myalgia (45.8%), false labour pain (37%), and headache (11.4%).
Conclusions: Study showed that there is a positive association between analgesics exposure during third trimester of pregnancy particularly to paracetamol exposure and preterm delivery. Association between paracetamol exposure and low birth weight was also observed in this study but this finding could be due to more number of preterm deliveries which could not be ruled out in this study. Further studies have to be conducted to confirm the association since there are only limited numbers of studies done till now.
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