A new study led by researchers at the USC Mann School found that prescription medications with potential fetal risks remain commonly used among women of reproductive age, including those who are pregnant.
Published in Reproductive Health, the study analyzed nationally representative data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. The researchers found that while overall prescription medication use increased among pregnant women during the study period, the use of at least one medication with potential fetal risks remained consistently high. They also observed a significant increase in pregnant women taking two or more potentially harmful medications. The study was also the first to examine potentially harmful drug use among non-pregnant women stratified by use of hormonal contraceptives.
Antidepressants were the most frequently used medications with potential fetal/newborn risks among women of reproductive age. Among pregnant women, antidepressant use increased nearly threefold, from 2.6% to 7.1%, driven largely by increased use of sertraline (Zoloft) during the study period. Moreover, a concerning increase was seen in contraindicated drug use in those on hormonal contraceptives (1.6% to 5.3%; p=0.03), a population who may perceive full protection against fetal harm.
The study was led by Dima M. Qato, Hygeia Centennial Chair and associate professor at the USC Mann School and Irving Steinberg, professor of clinical pharmacy and pediatrics at the USC Mann School and the Keck School of Medicine of USC, who served as the study’s senior author.
The researchers say the findings underscore the importance of balancing maternal mental health needs with medication safety during pregnancy. They also highlight the need for continued monitoring of prescription medication use and greater awareness of pregnancy-related safety risks, particularly of antidepressants, to support informed treatment decisions for women of reproductive age.