Drug Use Pattern and Antenatal Care Utilization among Pregnant Women in the First Trimester: A Cross-Sectional Study in a Tertiary Care Hospital in Eastern India

Abstract Background: Medication use during pregnancy requires caution due to altered pharmacokinetics and possible teratogenic effects. Early antenatal care (ANC) offers a vital opportunity for rational prescribing and preventing unsafe self-medication. However, few Indian studies have systematically explored drug use in early pregnancy. This study assessed prescribing patterns and self-medication practices during the first trimester of pregnancy in a tertiary care setting in Eastern India. Materials and Methods: A cross-sectional study was conducted among 250 pregnant women (≤12 weeks gestation) attending their first ANC visit at Calcutta National Medical College, Kolkata, from October 2024 to March 2025. Data were collected through a structured, interviewer-administered questionnaire. Drugs were classified using the WHO Anatomical Therapeutic Chemical system and United States Food and Drug Administration pregnancy risk categories. Descriptive statistics and multivariate logistic regression were used. Results: All participants were registered for ANC in the first trimester. Prescriptions were reported by 84.8%, mainly iron–folic acid (90%) and tetanus toxoid (84.8%). Only 36% received counseling on deworming; 15.2% had already taken albendazole, mostly before ANC registration. Self-medication was reported by 20%, mostly involving paracetamol, antacids, and herbal remedies. No contraindicated drugs were prescribed. Self-medication was significantly associated with lower education (adjusted odds ratio [AOR] = 3.9; 95% confidence interval [CI]: 1.8–8.5; P = 0.001), rural residence (AOR = 2.6; 95% CI = 1.3–5.3; P = 0.006), and being a housewife (AOR = 2.2; 95% CI = 1.0–4.9; P = 0.045). Conclusion: Despite rational prescribing, self-medication and limited counseling remain challenges. Strengthening ANC-based education is essential.