Profiling the pattern of medication use during pregnancy: an international scoping review of observational studies

INTRODUCTION: Medication use during pregnancy has increased significantly worldwide. However, detailed evidence on prescribing patterns during pregnancy remains limited. This scoping review aimed to summarize and provide a comprehensive global overview of the patterns/types of medications used during pregnancy. AREAS COVERED: The Joanna Briggs Institute (JBI) methodology was followed. PubMed, Ovid MEDLINE, Scopus, Web of Science, and EMBASE were searched for population-based and large multicentre observational studies published between January 2010 and April 2024. The included studies focused on pregnant women, investigated and quantified medications use during pregnancy. Identified medications were summarized narratively using the Anatomical Therapeutic Chemical (ATC) and the United States Food and Drug Administration (US-FDA)/Australian Therapeutic Goods Administration (AU-TGA) risk classification systems, and stratified by trimesters. EXPERT OPINION: Of 7,552 studies, 83 were eligible. The most frequently reported ATC categories were alimentary tract and metabolism (A, 0-96%), blood and blood-forming organs (B, 0-84.5%), nervous system (N, 0-73.3%), anti-infectives (J, 0-56%), and respiratory system (R, 0-51.3%). However, limited research provided trimester-specific information. Additionally, risk category A exhibited the widest prevalence range, 0-73.1%, while the higher-risk categories, D and X, were at 0-22.6% and 0-8.3%, respectively. This review highlights the need for further trimester-specific studies.