Prevalence of polypharmacy in pregnancy: a systematic review

Astha Anand, Katherine Phillips, Anuradhaa Subramanian, Siang Ing Lee, Zhaonan Wang, Rebecca McCowan, Utkarsh Agrawal, Adeniyi Fagbamigbe, Catherine Nelson-Piercy, Peter Brocklehurst, Christine Damase-Michel, Maria Loane, Krishnarajah Nirantharakumar*, Amaya Azcoaga-Lorenzo, MuM-PreDiCT Group

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Objectives The use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes.

Design MEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included.

Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed.

Results Fourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy.

Conclusion There is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms.
PROSPERO registration number CRD42021223966.
Original languageEnglish
Article numbere067585
Number of pages11
JournalBMJ Open
Issue number3
Publication statusPublished - 7 Mar 2023


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