Counselling
or prescribing drugs during pregnancy requires health professionals
to assess risk/benefit ratio for women and their baby. A misperception
of the risk may lead to inappropriate decisions for pregnancy
outcomes.
The aim of the present study was to assess teratogenic and/or
foetotoxic risk perception of common medications by general practitioners
(GPs) and community pharmacists (CPs) from the Midi-Pyrenees area.
Methods: 103 GPs and 104 CPs were interviewed. For 21 given drugs,
a visual-analogue scale was used to evaluate the risk to give
birth to a malformed infant if the mother had taken the drug during
first trimester of pregnancy. For 9 drugs, health professionals
had to say if they thought there was a potential foetotoxic and/or
neonatal risk when drugs were administered during late pregnancy.
Results: 97% and 91% of GPs and CPs respectively thought that
isotretinoin and thalidomide are teratogenic and more than 80%
thought that amoxicillin and acetaminophen are safe in early pregnancy.
However, 19% of the GPs and 33% of CPs answered there were no
teratogenic risk for valproate. Around 11% of both GPs and CPs
said that warfarin was safe during pregnancy. For 22% of GPs and
for 13% and 27% of CPs respectively, ibuprofen and enalapril were
safe on late pregnancy. For each drug, mean value of perceived
teratogenic risk by health professionals was higher than values
that can be found in scientific references. Concerning isotretinoin,
thalidomide and metoclopramide, perceived teratogenic risk was
higher for CPs.
Conclusion: These data show that the potential teratogenic and
foetotoxic risk of several commonly used drugs is unknown by health
professionals. Conversely, GPs and CPs who think that a risk exists,
overestimate it. This misperception can lead to inappropriate
decisions for pregnancy outcomes.
