Identifying Potentially Teratogenic Medications Prescribed to Women of Reproductive Age
Regina Ginzburg, College of Pharmacy and Health Sciences, Department of Clinical Pharmacy Practice
Abstract: A teratogenic medication is one that can potentially harm a fetus. In the US, 11.7 million prescriptions that are potentially teratogenic are dispensed to women of reproductive age annually. Previous research showed that only half of reproductive aged women who received a pregnancy category D or X medication prescription obtain contraceptive counseling or are informed they are taking a potentially teratogenic medication from their healthcare provider.
We performed a retrospective cohort study to estimate how many women of reproductive age in our community healthcare center were prescribed a potentially teratogenic medication and did not have adequate documentation for counseling or contraception while on this medication.
Of the 679 electronic charts that were reviewed, 51.3% of women prescribed a potential teratogen were considered high risk for pregnancy (no documentation of contraception, abstinence, or discussion of risk-benefit with patient). There was no difference among age and health insurance status. Race, however, was a positive predictor for documentation of contraceptive plan.
There is a huge need for raising awareness among physicians on which medications are considered teratogenic and to inform women of childbearing age of the possible risks involved should the women become pregnant. This study prompted our institution to develop and implement a best practice alert (BPA) that will present on the computer screen when a provider orders a potential teratogen. The BPA will be linked to contraceptive diagnosis and prompt the physician to provide contraceptive counseling or document risk-benefit of medication.