Drug exposure in early pregnancy might be related to the effects of increased maternal progesterone in implantation period

Abstract

Aim: This short communication aims to evaluate the relation in between drug exposure time and early pregnancy regarding gestational weeks.

Methods: The study covers the referrals made to the Department of Pharmacology for a teratogenic consultation in a 3-year period. From the recordings of pregnant women, the last menstrual period and the starting date of medication were used to determine the time of prescription with regard to gestational weeks.

Results: In all of the three years, potentially teratogenic medication was prescribed more frequently in the 3rd, 4th and 5th gestational weeks (in between 15–35 days of pregnancy). Approximately 75% of the pregnant women in the study were prescribed with drugs, most frequently with analgesics, antibiotics, gastrointestinal drugs and antidepressants, in these gestational weeks.

Conclusions: The timing of prescriptions in early pregnancy frequently coincides with the increased levels of maternal progesterone in implantation period. Progesterone may lead to negative mood symptoms of an increased pain perception, anxiety, irritability and aggression in some of the pregnant women and therefore causes an increased stress condition which in turn may result in pain, infection and inflammation in the individual. Taking the frequently used medications into consideration, the reason for prescriptions in this period might be related to the symptoms originating from the effects of progesterone. Future studies are needed to better demonstrate this association of drug exposure and effects of maternal progesterone in early pregnancy.

Keywords:

• Drug exposure
• early pregnancy
• implantation period
• progesterone
• teratogenicity

Acknowledgements

The authors would like to thank to Dr. Omer Demir for his help and his assistance in the preparation of the recording form. The authors would like to thank to the Obstetric Clinic in Adnan Menderes University for their help and assistance in the referral of pregnant women.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Current knowledge on the subject:

• The most frequent drug exposure takes place in the first trimester of pregnancy in which the embryo is most sensitive to teratogens.

• The main reason of drug exposure in early pregnancy is that neither the women nor the prescribers are aware of the possible pregnancy at the time of prescription.

• There are no reports in literature which evaluates the timing of drug exposure with regard to gestational weeks.

What this study adds:

• This report is the first to evaluate drug exposure in early pregnancy with regard to gestational weeks.

• The most frequent prescription of drugs takes place in between 15-35 days of pregnancy, which coincides with the increased levels of maternal progesterone in the implantation period.

• Regarding the types of frequently used medication in this period, the reason for prescriptions might be related to the symptoms originating from the effects of progesterone.