Drug intake behaviour of immigrants during pregnancy

Abstract

Objective:

To assess differences between native Spanish and immigrant pregnant women in behaviour relating to the use of medications during pregnancy.

Study design:

This cross-sectional study was carried out at the department of obstetrics and gynaecology of an acute-care teaching hospital in the city of Barcelona, Spain. A total of 1103 women who gave birth at the hospital during a 1-year period were enrolled in the study. Each woman was interviewed by a gynaecologist during her stay in hospital after delivery, with special reference to drug use during the pregnancy. Drug exposure was assigned to trimesters, and drugs were divided into therapeutic groups, while the women taking part were divided up by nationality, educational level, parity and age. Data were analysed using bivariate, multivariate, and cluster analyses.

Results:

Slightly over half (55.7%) of the women were native to Spain and 44.3% were immigrants of other nationalities. About a quarter, or 25.4%, of pregnant patients had not taken any drugs during their pregnancies. The most frequent drugs taken by the others were vitamins, which were used mostly by Spanish women, followed by analgesics, which were mostly taken by non-Spanish western women. The largest group who had taken folic acid was made up of non-Spanish western women, while the Asiatic patients had taken this in the smallest proportion of cases.

Conclusions:

Spanish patients and immigrants from other western countries showed a similar behaviour in terms of drug intake during pregnancy, which was different from the behavioural patterns seen in pregnant patients from developing countries.

Introduction

At present, clinical recommendations advise that aking drugs should not be taken during pregnancy, with the exception of any that are necessary for the expectant mothers’ health during the pregnancy. In the early 1960s, with the recognition of thalidomide as the drug responsible for severe congenital abnormalities in newborns, the term “teratogenic” was coined [1]. When any medication is prescribed during pregnancy, the possible risks and benefits that the drug could have for both the mother and the fetus have to be assessed [2], [3], [4]. On the other hand, in 1980, a first study showing the possible prophylactic effects of folic acid supplementation against the development of neural tube defects prompted the publication of an international consensus paper on the benefits of folic acid supplementation during the first trimester of pregnancy [5], [6]. The intake of drugs during pregnancy in Spain has been described in other studies [7], [8], [9], [10] conducted under the sponsorship of the European Regional Office of the World Health Organisation, but the use of drugs among the immigrant population, which is constantly increasing in size with the increasingly frequent waves of migration in Europe, has not been assessed previously.

Therefore, the aim of this study was to compare the behavioural pattern relating to drug use during pregnancy in two population groups of pregnant women, Spaniards and immigrants, taking advantage of the fact that the hospital in which the study was carried out is the medical referral centre of an area in the city of Barcelona in which a large number of immigrants are concentrated. In particular, in the Service of Obstetrics and Gynaecology at this centre, about 40% of babies are born to women of non-Spanish origin.