Heikkilä A M, Erkkola R U, Nummi S E
Department of Obstetrics and Gynaecology, Turku University Central Hospital, Finland.
Ann Chir Gynaecol Suppl. 1994;208:80-3.
Pregnancy is associated with special problems with respect in selection of medication and dosage, primarily due to potential teratogenic or toxic effects on the fetus by the drug itself, and secondly due to the physiologic adjustments in the mother in response to pregnancy. This prospective survey was designed to record the use of medications and the policy of prescribing during the course of pregnancy. In total, 5851 pregnant women residing in a county in southwestern Finland during the period June 15, 1987 and June 14, 1988 were studied, which is 69% of the total amount of births in the same area. Iron and vitamin supplementation was used by all the pregnant women during the third trimester, and by 35% and 88% during the first and second trimesters, respectively. Analgetics were used on an irregular basis by 12% of the pregnant women, and no correlation to the length of pregnancy could be observed. 9% of the women used medication on a regular basis for reasons such as bronchial asthma, arterial hypertension and hyperthyreosis. Some kind of a symptomatic medication was taken by 43% of the women with no correlation of the length of pregnancy, the most common symptoms needing medication being candidiasis, cough, reflux esophagitis and pregnancy-associated hyperemesis. Tocolytic agents had been given to 8% of the pregnant women. Most tocolytics were used during the end of the second trimester and beginning of the third one. It is concluded that the general use of medicines is quite reasonable in the normal pregnant population in Finland. Iron supplementation should probably be more individualized instead of regular use.
妊娠在药物选择和剂量方面存在特殊问题，主要是因为药物本身可能对胎儿产生致畸或毒性作用，其次是由于母亲在孕期会发生生理调节。这项前瞻性调查旨在记录孕期用药情况和处方政策。1987年6月15日至1988年6月14日期间，对居住在芬兰西南部一个县的5851名孕妇进行了研究，占该地区同期出生总数的69%。所有孕妇在孕晚期都补充了铁和维生素，在孕早期和孕中期补充的孕妇分别占35%和88%。12%的孕妇不定期使用镇痛药，未观察到与孕期长短有相关性。9%的女性因支气管哮喘、动脉高血压和甲状腺功能亢进等原因定期用药。43%的女性服用了某种对症药物，与孕期长短无关，最常见的需要用药的症状是念珠菌病、咳嗽、反流性食管炎和妊娠剧吐。8%的孕妇使用了宫缩抑制剂。大多数宫缩抑制剂在孕中期末和孕晚期初使用。结论是，芬兰正常孕妇群体的总体用药情况相当合理。铁补充剂可能应更个体化使用，而非常规使用。
