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Utility of reproductive life plans in identification of potentially teratogenic medication use: A pilot study

BACKGROUND
Teratogenic medications increase risks of miscarriage, fetal death, and/or birth defects. It is important to identify whether women of childbearing potential are taking these medications and to minimize exposure to these agents through change in drug therapy before conception and/or use of effective contraception to prevent conception.


OBJECTIVE
To determine the utility of reproductive life plans as tools to identify women using potentially teratogenic medications.


METHODS
A retrospective review was conducted on reproductive life plans completed by women receiving services as part of the Toledo-Lucas County Healthy Start program. The medication section of the reproductive life plan was reviewed to determine: if it was completed; categories of medications reported (prescription, over-the-counter, vitamin/herbal); potentially teratogenic medications listed; contraception use and method.


RESULTS
Medication lists were completed for 437 of the 580 reproductive life plans reviewed (75%). Thirty-five women (8%) reported use of a potentially teratogenic medication; most commonly reported agents included blood pressure medications and antidepressants. Only 10 women taking a potentially teratogenic medication (29%) reported using some form of contraception, half of which reported use of a less effective method such as condoms.


CONCLUSION
The reproductive life plan can be a useful tool to identify women of childbearing age who require intervention due to use of potentially teratogenic medications. Efforts are needed to ensure complete and accurate reporting of medication use in reproductive life plans, and to promote effective contraceptive use among women taking potentially teratogenic medications.