Drugs in pregnancy: a Q&A with parents

By Rachel Plachcinski (based on Q&A held on the Bump2Baby group with Professor Peter Brocklehurst)

A big issue highlighted by the MuM-PreDiCT patient and public involvement group is the lack of information available to women and families about medication use during pregnancy. This is a difficulty for anyone who is pregnant, and even more challenging for women and birthing people who are taking medication for long term health conditions.

Fortunately, there is work in progress to improve this situation. MuM-PreDiCT has a team focussing on polypharmacy, the use of several medications at the same time, and Professor Peter Brocklehurst, one of the MuM-PreDiCT co-investigators, has led on the production of the new report Healthy Mum, Healthy Baby, Healthy Future: The Case for UK Leadership in the Development of Safe Medicines for Use in Pregnancy.

We wanted to give more parents the opportunity to ask questions about this important issue, so we worked with the Bump2Baby parents voices group on Facebook to set up a Q&A with Prof Brocklehurst.  

Prof Brocklehurst explained that, as a consequence of the thalidomide scandal, virtually no drug treatments had been developed that were approved for use in pregnancy since the 1960s.

He is particularly keen to see the development of new therapies for pregnancy conditions such as preterm labour and pre-eclampsia, commenting: “Imagine if as much effort went into preventing preterm birth as went into HIV/AIDS in the early years.”

Bump2Baby members also flagged up the need for more treatment options for women and birthing people experiencing severe sickness (hyperemesis gravidarum), gestational diabetes and severe itching (intrahepatic cholestasis of pregnancy).

The recommendations in the report include setting up a central source of advice on drug use during pregnancy that can be used by both health professionals and the public, and for researchers developing new drugs (for all health conditions) to include pregnant women and birthing people in the testing process whenever they can. However, Bump2Baby members were unsure whether they would consent to take part in trials whilst pregnant, and it was suggested that this may depend on whether you had previous experience of health problems, both before and during pregnancy.

Prof Brocklehurst stressed how important it was that the voice of pregnant women and birthing people was at the heart of this initiative, as this would help to rebuild trust in medication and drug trials. “We need to find a way to make this work otherwise babies and mothers will continue to die or suffer because of a lack of effective and safe medicines, so we need to work together to find that way forward.”

That chat included lots of interesting insights into the different strands of work necessary to improve the situation, such as more discovery science, so we can better understand the physical processes that lead to pregnancy complications; the development of pregnancy toxicology models to test medicines before they are used on humans, and the networking and collaboration needed to get different groups, from patients to health professionals to pharma companies, working together effectively.

You can read the full Q&A transcript in the Bump2Baby group files on Facebook. Bump2Baby was set up by Rachel Plachcinski, patient and public involvement lead on MuM-PreDiCT, and Eleanor Mitchell, Associate Professor of Clinical Trials at the University of Nottingham, to give parents greater opportunities to learn about and contribute to the development of maternity research projects.

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