Abstract

Background and aim. Use of prescription medicines during pregnancy has been increasing worldwide. At the same time, discrepancies between online information sources regarding medicine use during pregnancy are common. The aim of the current study was to analyse and compare the use of prescription medicines during pregnancy in Estonia in 2019 and 2008 and to analyse the information about the safety of medicine use during pregnancy in different databases.
Methods. A retrospective study was carried out in 2021 using the health service and prescription data of the Estonian Health Insurance Fund.

Results. The use of prescription medicines has decreased: in 2008 75% of the pregnant women used prescription medicines,
while in 2019 their proportion was 68%. The median number of prescriptions per pregnancy was 2 in both years. The most common diagnosis was infertility in 2019 (12.6% of prescriptions compared to 3.4% in 2008). There were 380 active substances prescribed in 2019, of which 7.7% were officially indicated to pregnant patients according to the SPC and 42.6% were contraindicated. However, 20% were indicated and 7.6% contraindicated according to the Gravbase. Only 19% (73 active substances) belonged to the same risk category according to the different data sources.
Conclusion. As the SPCs often lack data about the risks related to the medicines use during pregnancy, accessibility of trustworthy databases for doctors, nurses and pharmacists is of great importance.