Drugs during pregnancy methodological aspects PDF
TheDrugs during pregnancy methodological aspects PDF use of drugs during pregnancy may affect embryonic and/or fetal development. Most feared is perhaps an increase of the malformation risk. It should be realized that maternal drug use is a relatively rare cause of congenital malformations. In perhaps 25 % of such instances, genetic conditions explain the malformation, in a few percent nongenetic factors are identified, but in the remaining cases no direct explanation to the event exists. It is then easy to look for an explanation, e.g., by postulating effects of maternal drug use. As will be explained in the text, the most crucial evidence comes from epidemiological investigations.
Drugs during pregnancy methodological aspects PDF, however, are often burdened by uncertainty, and it is easy to jump to conclusions. For the individual, risks from drug exposure are often so low that they hardly matter: if a woman has a 3 or a 4 % probability to have a malformed infant is of little signifi cance for her, but if the drug is commonly used, even a weak effect may play a role as it can cause many malformed infants.
Drugs during pregnancy methodological aspects PDF following text, examples are given from the Swedish Medical Birth
Register. This register started in 1973 and was then based on documents summarizing the pregnancies. These were prepared after delivery by secretaries at the obstetric clinics (practically all births in Sweden take place in hospitals). Since 1982, data
have instead been taken from copies of the original medical records which have the same format in all delivery units. With the introduction of computer-based medical records, transfer of information can be made electronically. The register contains much medical information and is supplemented with some data from Statistics Sweden. Information on factors of interest in early pregnancy (e.g., smoking, mater-nal weight, height, drug use) is based on interviews made by the midwives at the woman’s fi rst visit to the prenatal care (usually in week 10–12) and is thus prospective related to possible complications during pregnancy and in the neonate. Very few women do not attend prenatal care which is free of charge. Beginning on July 1, 994, the information on drug use obtained from midwife interviews and from medical records during prenatal care was included in the register. Outcome data were obtained from the delivery records and from the pediatric examination of the newborn – all newborn infants are examined by a qualifi ed pediatrician