Risks versus benefits of medication use during pregnancy: What do women perceive?

Background: Understanding risk perception is essential in designing good risk communication strategies. It has been reported that women overestimate the teratogenic risk of medication use, but these studies didn't include perceived benefits and major concerns of pregnant women regarding medication use. Objectives: The aim of this study was to evaluate the perception of risks, benefits and major concerns regarding medication use during pregnancy. Methods: Questionnaires were handed out to all pregnant women who attended a Dutch obstetric facility for first and second line care. Patients were asked to score the benefits of 7 drug groups on a scale from 1-7 (Benefit-score (BS)). Second, patients were asked to rate the probability and severity of an event occurring due to use of the 7 drug groups on a scale from 1-7. Risk scores (RS) were constructed by multiplication of the measures of perceived probability and severity. To make the RSs comparable to the BSs a square root extraction of the RS was performed. Third, patients were asked about the level of concern of different unfortunate events resulting from medication use. Results: Results are preliminary A total of 118 eligible women completed the questionnaire (response rate 77%). More than 80% of the women used medication during pregnancy. Paracetamol (RS = 2.0, BS = 4.7), antacids (RS = 2.8, BS = 4.2) and antibiotics(RS = 3.3, BS = 4.6) were perceived relatively low in risk and high in benefit. Sedatives (RS = 5.2, BS = 3.9) and NSAIDS (RS = 4.7, BS = 3.2) were perceived relatively high in risk and low in benefit. Pregnant women were most concerned about having a child with a congenital birth defect (38.1%), a miscarriage (36.0%) or having a child with an allergic disease (25.7%), respectively as a result of drug use. Conclusions: Though it has been reported that women overestimate teratogenic risk of medication use, this study showed that most of the drugs were perceived relatively low in risk and high in benefit. In addition this study shows the different concerns women have regarding medication use during pregnancy. Health care providers in first and second line care obstetric facilities can take this into account when counselling pregnant women.