Assessment of risk perception of teratogenicity of commonly used drugs among pregnant women

Abstract

Background: Drug therapy in pregnancy is common practice and most women are concerned about effects of drugs to the unborn child. Objective: To determine the teratogenicity risk perception of commonly used medicines among pregnant women. Method: A cross-sectional descriptive survey was conducted at five antenatal clinics in Harare. An interviewer administered questionnaire which collected information on socio- demographic characteristics, information sources, medicine use, risk perception and health beliefs was used. Descriptive and bivariate statistics was used to analyze the data. Multivariate linear regression and logistic regression analysis were conducted to identify predictors of risk perception and medication use in pregnancy respectively. Results: Out of 450 women approached, 368(81.3%) agreed to participate in the study. The majority (70.9%) of the women used medicines during pregnancy. Paracetamol (48.6%), magnesium trisilicate (31.5%), ferrous sulphate (25.5%), folic acid (20.4%) and methyldopa (15.2%) were the most commonly used drugs. The majority (70.4%) estimated correctly the baseline teratogenic risk to be <5%. In bivariate analysis, women who had health related jobs (.2=13.592, p=0.0005) and multiparious (.2=45.403, p=0.0005) were more likely to use medicines during pregnancy. Similarly, multiparious women (p=0.0005), women with health related jobs (p=0.003) and women with at least secondary level of education (p=0.048) had a lower risk perception. In multiple linear regression, parity (ß=-0.155, p=0.004), perceived danger (ß=0.215, p=0.001), perceived severity from harm (ß=0.292, p=0.005), perceived barrier to not taking medicines (ß=-0.095, p=0.041) and cues to action (ß=0.101, p=0.025) were significant predictors of risk perception. In logistic regression, parity (OR=9.525; 95% C.I: 3.848; 23.575; p=0.005), personal exemption from harm (OR=0.809; 95% C.I: 0.686; 0.954; p=0.012), perceived danger (OR=1.210; 95% C.I: 1.053; 1.390; p=0.007) and perceived barriers to not taking medicines (OR=0.754; 95% C.I: 0.643; 0.885; p=0.001) were significant predictors of medicine use. Conclusion: Although medication use was high among pregnant women, the majority overestimated the teratogenicity risk associated with individual medicines. There is need for health care providers to play a bigger role in provision of pregnancy related drug information so that positive attitudes and beliefs concerning medication use in pregnancy are reinforced. Key words: Risk perception, Pregnancy, Medication, Beliefs