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Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study

Globally, innumerable women take medication while they are pregnant, and this trend is growing. The pipeline of medicines targeting maternal comorbidities is expanding. However, for most medicines, there is insufficient data on their safety in pregnancy. In addition, women may be taking medication f...

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Main Author: Elzouki, Zaineb
Other Authors: Mehta, Ushma
Format: Thesis
Language:English
Published: Department of Medicine 2023
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access_status_str Open Access
author Elzouki, Zaineb
author2 Mehta, Ushma
author_browse Elzouki, Zaineb
Mehta, Ushma
author_facet Mehta, Ushma
Elzouki, Zaineb
author_sort Elzouki, Zaineb
collection Thesis
description Globally, innumerable women take medication while they are pregnant, and this trend is growing. The pipeline of medicines targeting maternal comorbidities is expanding. However, for most medicines, there is insufficient data on their safety in pregnancy. In addition, women may be taking medication for chronic or acute conditions before they recognize that they are pregnant. This study compared the self-reported pattern of medicine use during the course of pregnancy in a cohort of pregnant women either living with or without HIV; seeking care at Gugulethu primary health care obstetric clinic in Western Cape, South Africa. Data on medicine use was collected over 3 antenatal visits. Medications reported were manually classified and coded by a clinical pharmacist and medical doctor. Structured interviews using a detailed questionnaire on medication use were administered to n=989 pregnant women. Women who had an ectopic pregnancy or an elective termination of pregnancy (TOP) were excluded from the analysis. 982 of these women were included in our analysis (n=507 HIV-negative and n=475 HIV positive). Of these, 39 (4.0%) did not report taking any medicine during pregnancy. Most 907 (92.3%) pregnant women reported using at least one over-the-counter medicine (OTC) and the majority, 601 (61.2%), at least one prescription medicine. A total of 36 (3.7%) reported using at least one herbal or traditional medicine over the course of the pregnancy. Pregnant women living with HIV were significantly less likely to report use of OTC medicine (56.2% vs 77.7%, p=<0.001). Pregnant women living with HIV also reported less herbal medicine use (2.9% vs 4.7%, p=0.07) compared to pregnant women living without HIV, though the effect was non-significant within this sample. Excluding antiretroviral medicines, prescription medicine use was essentially the same among pregnant women living with and without HIV (30.5% vs 30.2%, p=0.96). Exposure to medicines known to be potentially teratogenic or unsafe in pregnancy was reported in 300 (30.65%) pregnant women, with aspirin 238 (24.2%) and nonsteroidal anti-inflammatory medicines 46 (4.7%) medicines being the most reported. This study provides valuable information on self-reported medication use among pregnant women living with and without HIV in a South African primary healthcare setting. Medicine use was widespread in the study cohort, particularly OTC, with high prevalence of potentially unsafe medicines used during pregnancy. Our finding highlights the urgent need to build awareness around rational and safe medicine use among antenatal staff; pharmacists; and women of child-bearing age in South Africa, encouraging the taking of a thorough history of medicine exposure throughout the antenatal period.
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institution University of Cape Town (South Africa)
language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
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spelling oai:open.uct.ac.za:11427/37177 Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study Elzouki, Zaineb Mehta, Ushma Blockman, Marc Clinical Pharmacology Globally, innumerable women take medication while they are pregnant, and this trend is growing. The pipeline of medicines targeting maternal comorbidities is expanding. However, for most medicines, there is insufficient data on their safety in pregnancy. In addition, women may be taking medication for chronic or acute conditions before they recognize that they are pregnant. This study compared the self-reported pattern of medicine use during the course of pregnancy in a cohort of pregnant women either living with or without HIV; seeking care at Gugulethu primary health care obstetric clinic in Western Cape, South Africa. Data on medicine use was collected over 3 antenatal visits. Medications reported were manually classified and coded by a clinical pharmacist and medical doctor. Structured interviews using a detailed questionnaire on medication use were administered to n=989 pregnant women. Women who had an ectopic pregnancy or an elective termination of pregnancy (TOP) were excluded from the analysis. 982 of these women were included in our analysis (n=507 HIV-negative and n=475 HIV positive). Of these, 39 (4.0%) did not report taking any medicine during pregnancy. Most 907 (92.3%) pregnant women reported using at least one over-the-counter medicine (OTC) and the majority, 601 (61.2%), at least one prescription medicine. A total of 36 (3.7%) reported using at least one herbal or traditional medicine over the course of the pregnancy. Pregnant women living with HIV were significantly less likely to report use of OTC medicine (56.2% vs 77.7%, p=<0.001). Pregnant women living with HIV also reported less herbal medicine use (2.9% vs 4.7%, p=0.07) compared to pregnant women living without HIV, though the effect was non-significant within this sample. Excluding antiretroviral medicines, prescription medicine use was essentially the same among pregnant women living with and without HIV (30.5% vs 30.2%, p=0.96). Exposure to medicines known to be potentially teratogenic or unsafe in pregnancy was reported in 300 (30.65%) pregnant women, with aspirin 238 (24.2%) and nonsteroidal anti-inflammatory medicines 46 (4.7%) medicines being the most reported. This study provides valuable information on self-reported medication use among pregnant women living with and without HIV in a South African primary healthcare setting. Medicine use was widespread in the study cohort, particularly OTC, with high prevalence of potentially unsafe medicines used during pregnancy. Our finding highlights the urgent need to build awareness around rational and safe medicine use among antenatal staff; pharmacists; and women of child-bearing age in South Africa, encouraging the taking of a thorough history of medicine exposure throughout the antenatal period. 2023-03-03T09:18:05Z 2023-03-03T09:18:05Z 2022 2023-02-20T12:43:59Z Master Thesis Masters MPhil http://hdl.handle.net/11427/37177 eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle Clinical Pharmacology
Elzouki, Zaineb
Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
thesis_degree_str Master's
title Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
title_full Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
title_fullStr Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
title_full_unstemmed Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
title_short Self-Reported Antenatal Medicines Use Among Women Living with and Without HIV in Western Cape, South Africa: A Sub-Analysis of the B Positive Cohort Study
title_sort self reported antenatal medicines use among women living with and without hiv in western cape south africa a sub analysis of the b positive cohort study
topic Clinical Pharmacology
url http://hdl.handle.net/11427/37177
work_keys_str_mv AT elzoukizaineb selfreportedantenatalmedicinesuseamongwomenlivingwithandwithouthivinwesterncapesouthafricaasubanalysisofthebpositivecohortstudy