PT  - JOURNAL ARTICLE
AU  - Eline Houben
AU  - Karin MA Swart
AU  - Eric AP Steegers
AU  - Petra JM Elders
AU  - Ron MC Herings
TI  - GPs’ awareness of pregnancy: trends and association with hazardous medication use
AID  - 10.3399/BJGP.2022.0193
DP  - 2023 Jan 01
TA  - British Journal of General Practice
PG  - BJGP.2022.0193
4099  - http://bjgp.org/content/early/2023/01/23/BJGP.2022.0193.short
4100  - http://bjgp.org/content/early/2023/01/23/BJGP.2022.0193.full
AB  - Background GPs have been shown to be important providers of medical care during pregnancy, however, little evidence exists on their awareness of pregnancy when prescribing medication to women.Aim To assess GPs’ awareness of pregnancy and its association with prescribing medication with potential safety risks.Design and setting Population-based study using confirmed pregnancy records linked to GP records from the PHARMO Perinatal Research Network.Method GPs’ awareness of pregnancy, defined as the presence of a pregnancy confirmation in the GP information system during pregnancy, was assessed from 2004 to 2020. GP prescriptions of medication with potential safety risks were selected during pregnancy and its association with GPs’ awareness of pregnancy was assessed using multivariable logistic regression.Results A pregnancy confirmation was present in the GP records for 48% (n = 67 496/140 976) of selected pregnancies, increasing from 28% (n = 34/121) in 2004 to 63% in 2020 (n = 5763/9124). During 3% (n = 4489/140 976) of all pregnancies, the GP prescribed highly hazardous medication with teratogenic effects that should have been (temporarily) avoided. Pregnancy was GP confirmed for only 13% (n = 585/4489) at the first occurrence of such a prescription. Comparative analyses showed that women without a pregnancy confirmation were 59% more likely to be prescribed this highly hazardous medication (odds ratio [OR] 1.59, 95% confidence interval [CI] = 1.49 to 1.70) compared with those with a confirmed pregnancy.Conclusion Results of this study indicate a potential issue with GP awareness about pregnancy status at the time medication with potential safety risks is prescribed. Although pregnancy registration by GPs improved over the years, inadequate use still seems to be made of the available information systems for appropriate drug surveillance.