Use of drugs known to cause fetal harm among women delivering infants in Haiti

Abstract

Objective: To estimate the prevalence of use of fetal-harm drugs among women who received postpartum care in hospitals in Haiti and to identify groups of women at higher risk for potentially harmful medication exposures.

Methods: Women who received postpartum care in 2 large hospitals in Port-au-Prince, Haiti, from August 18 to December 1, 2008, were surveyed in Creole about their use of medications in pregnancy, including fetal-harm drugs.

Results: We surveyed 482 women who had a median age of 26 years. Approximately 75% reported using at least 1 medicine in pregnancy, with the most common being amoxicillin (n = 127), acetaminophen (n = 109), metronidazole (n = 79), and misoprostol (n = 38). More than 13% used fetal-harm drugs, including misoprostol and tetracycline. Unmarried women (adjusted relative risk [RR] 2.2; 95% confidence interval [CI], 1.0-4.7) and separated women (adjusted RR 4.6; CI, 1.8-11.9) were more likely than married women to report use of fetal-harm drugs. In addition, women with 4 or more children were more likely to report use of medications known to cause fetal harm (adjusted RR 4.3; CI, 1.9-9.9).

Conclusion: Women who delivered infants in Haiti commonly report use of fetal-harm drugs. The public health implications of these findings are broad and relate to complex issues such as pregnancy planning and regulation of medications to prevent potentially harmful exposures.