Prescription Status of Potentially Teratogenic Drugs to Women of Childbearing Age in the Emergency Department of a Teaching Hospital

ABSTRACT

PURPOSE: The purpose of this study is to survey the prescription status of potentially teratogenic drugs to women of childbearing age in an emergency department (ED). In addition, the frequency of documentation of patient's pregnancy status was also evaluated. METHODS: A retrospective study was conducted through the use of warehouse data at a tertiary care center. Women aged 20~39 years who were prescribed drugs that the U.S. Food and Drug Administration (FDA) identifies as class D or X were evaluated. The frequency of prescription of potentially teratogenic drugs and the rate of pregnancy tests performed at the ED were analyzed. RESULTS: Among the 7,742 women of childbearing age with ED visits, 1,962(25.3%) patients received at least one potentially teratogenic drug during 2006, based upon the FDA risk classification system. The most frequently prescribed drugs were non steroidal anti-inflammatory drugs (NSAID) (50.8%), opioid drugs(26.3%), and benzodiazepines(10.3%). The number of pregnancy tests performed before prescribing potentially teratogenic drugs was 838 (39.0%). Among patients for whom a pregnancy test was not performed, only 87(7.6%) patients were advised by their doctors of drug teratogenecity. CONCLUSION: The frequency of prescription of potentially teratogenic drugs to women of childbearing age was 1 in every 4 visits at the ED. In addition, the rates of documentation of pregnancy status and explanation of teratogenecity were relatively low. Introducing a pregnancy information system and a pregnancy alerting system, as well as increasing the frequency of pregnancy tests before prescribing are necessary, not only for pregnant women and fetuses but also for emergency medical personnel at the point of care.