Published: 2017-01-05

A study of drug utilization in indoor patients of high-risk pregnancy in a tertiary care hospital

Smita Laxman Gaidhankar, Shraddha Milind Pore, Milin Nanasaheb Deokate, Sunita Jaiprakash Ramanand, Arundhati Tukaram Salunke


Background: High-risk pregnancy is an important determinant of drug use during pregnancy. The aim of study was to evaluate drug use pattern according to WHO core-drug prescribing indicators and US-FDA pregnancy category in indoor patients of high-risk pregnancy.

Methods: It was a prospective, observational study. All high-risk pregnant women admitted to tertiary care hospital and willing to give consent were included. The data was collected from 290 patients over 12 months. The data was analysed to evaluate drug utilization according to WHO core drug use indicators and in relation to US-FDA pregnancy risk category.

Results: The study found that 74.82% of women were between 20-30 years of age and were admitted during third trimester of pregnancy. The most commonly prescribed drug class was vitamins and minerals prescribed in 82.75% patients. Average number of drugs per encounter was 6.4. Percentage of drugs prescribed by generic name and from essential drug list was 73.07% and 77.07% respectively. Percentage of encounters with an antibiotic and an injection prescribed was 29.31% and 65.17% respectively. The prescription of drugs belonging to US-FDA pregnancy drug categories A, B and C were 92.06%, 86.55% and 4.82% respectively.

Conclusions: Overall, the principles of rational prescribing were followed according to the various drug use indicators mentioned by the WHO and US FDA pregnancy risk category. Further studies are required to find out specific drug or drug therapy related problems and plan targeted interventions to improve drug use.


WHO core drug use indicators, US-FDA pregnancy drug category, Antihypertensives

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WHO International working group for drug statistics methodology. Introduction to drug utilization research. Oslo, Norway: WHO collaborating centre for drug utilization research and clinical pharmacology 2003. Available at Accessed 12 July 2015.

Daw JR, Hanley GE, Greyson DL, Morgan SG. Prescription drug use during pregnancy in developed countries: a systematic review. Pharmacoepidemiol Drug Saf. 2011;20(9):895-902.

De Jonge L, Bos HJ, van Langen IM, de Jong-van den Berg LT, Bakker MK. Antibiotics prescribed before, during and after pregnancy in the Netherlands: a drug utilization study. Pharmacoepidemiol Drug Saf. 2014;23(1):60-8.

Profit J, Goldstein BA, Tamaresis J, Kan P, Lee HC. Regional variation in antenatal corticosteroid use: a network-level quality improvement study. Pediatrics. 2015;135(2):e397-404.

Eurap study group. Utilization of antiepileptic drugs during pregnancy: comparative patterns in 38 countries based on data from the EURAP registry. Epilepsia. 2009;50(10):2305-9.

Bobo WV, Davis RL, Toh S, Li DK, Andrade SE, Cheetham TC, et al. Trends in the use of antiepileptic drugs (AEDs) among pregnant women in the U.S., 2001-2007: a medication exposure in pregnancy risk evaluation program (MEPREP) study. Paediatric and perinatal epidemiology. 2012;26(6):578-88.

Datta DC. Special topics in obstetrics. In: Konar H, ed. DC Dutta’s Textbook of obstetrics. 8th ed. New Delhi: Jaypee Brothers Medical Publishers; 2015:692-723.

Sharma R, Kapoor B, Verma U. Drug utilization pattern during pregnancy in North India. Indian J Med Sci. 2006;60(7):277-87.

Kumar MP, Gnanadeep NV, Dixit UR, Patil PS. Prevalence of high risk pregnancy in rural Dharwad. IOSR Journal of Dental and Medical Sciences. 2015;14(10):29-32.

Bharti, Kumar V, Kaur A, Chawla S, Malik M. Prevalence and correlates of high risk pregnancy in rural Haryana: a community based study. International Journal of Basic and Applied Medical Sciences. 2013;3(2):212-7.

Kumar S, Bansal D, Hota D, Jain M, Singh P, Pandey BL. Assessment of clinical outcomes and prescribing behavior among in patients with severe preeclampsia and eclampsia: an Indian experience. Indian J Pharmacol. 2014;46(1):18-23.

Schimmer BP, Parker KL. Contraception and pharmacotherapy of obstetrical and gynecological disorders. In: Brunton LL, Chabner BA, Knollman BC, eds. Goodman and Gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill; 2011:1833-1852.

WHO. How to investigate drug use in health facilities: selected drug use indicators. (WHO/DAP/93.1). Geneva: Action Programme on Essential Drugs, World Health Organization. 1993;1-87. Available at Accessed 15 February 2015.

Patel KP, Joshi HM, Patel VJ. A study of morbidity and drug utilization pattern in indoor patients of high risk pregnancy at tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2013;2(3):372-8.

Good clinical practice recommendations for iron deficiency anemia in pregnancy (IDA) in pregnancy in India. Journal of Obstetrics and Gynaecology of India. 2011;61(5):569-71.

WHO/UNICEF/UNU. Iron deficiency anaemia assessment, prevention, and control: a guide for programme managers. Geneva: World Health Organization; 2001. Available at Accessed 10 May 2015.

Gawde SR, Bhide SS, Patel TC, Chauhan AR, Mayadeo NM, Sawardekar SB. Drug prescription pattern in pregnant women attending antenatal outpatient department of a tertiary care hospital. British Journal of Pharmaceutical Research. 2013;3(1):1-12.

Reddy SB, Patil N, Hinchageri SS, Kamala S. Assessing the pattern of drug use among pregnant women and evaluating the impact of counseling on medication adherence among them. International Research Journal of Pharmacy. 2011;2(8):148-53.

Adhikari A, Biswas S, Gupta RK. Drug utilization pattern in pregnant women in rural areas, India: cross-sectional observational study. J Obstet Gynaecol Res. 2011;37(12):1813-7.

Joshi H, Patel S, Patel K, Patel V. Drug use pattern during pregnancy: a prospective study at tertiary care teaching hospital. NHL Journal of Medical Science. 2012;1(1):14-7.

Haas JS, Phillips KA, Gerstenberger EP, Seger AC. Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997-2000. Ann Intern Med. 2005;142(11):891-7.

MOHFW. Guidelines for Janani-Shishu Suraksha Karyakram (JSSK). New Delhi: Maternal Health Division, Ministry of Health and Family Welfare, Govt. of India 2011. Available at Accessed 10 July 2015.