Drug-prescribing challenges during pregnancy

Abstract 

Most women take either prescribed or over-the-counter medication during pregnancy. Pregnant women often make independent decisions about their treatment and require careful counselling that allows them to balance the risk of taking a drug against the risk of not taking a drug and leaving a medical condition untreated. Advice needs to be tailored to the individual and is hampered by the lack of safety data on drugs in pregnancy and the puerperium. Prescribing is further complicated by both the mother’s and the foetus’ changing physiologies as risk–benefit assessments alter throughout pregnancy. Treatment decisions may require the input of multi-disciplinary teams that consider the severity of the mother’s condition, maternal physiology, a drug’s pharmacokinetic, pharmacodynamic and safety profile and the developmental stage of the foetus.

Keywords: concordance, drug safety, pharmacokinetics, pregnancy, prescribing, teratogen