A questionnaire based survey on knowledge, attitude and practices of medical practitioners regarding the prescribing of medications during pregnancy

Gausia Banu, Afzal Khan A. K.


Background: Prescribing during pregnancy requires careful estimation of risk/benefit ratio for the mother and her baby. Both, underestimation and overestimation can produce undesirable maternal and fetal outcomes hence the present study was undertaken to assess the knowledge, attitude and practices (KAP) of medical practitioners related to the prescribing of medications during pregnancy.

Methods: A preformed structured questionnaire was administered to 41 medical practitioners. Multiple choice questions (MCQs) and yes/no type questions were used to assess their knowledge. Likert type questions studied their attitude and practices. Their perception of teratogenic risk of medications was evaluated using a visual analogue scale. The data so obtained was analyzed using descriptive statistics.

Results: Completed questionnaires were returned by 76% of the survey participants. Among whom only 24% felt highly confident while others were less confident or unsure regarding their prescribing ability during pregnancy. 90% of the respondents reported that a disease should not be untreated or undertreated due to fear of teratogenicity. 81% exhibited good knowledge of the FDA pregnancy categorization of drugs and more than 80% were aware of the teratogenic risk associated with valproic acid, lithium, isotretinoin, warfarin & thalidomide. The perceived risk of teratogenicity (mean) suggested for them was 33, 52, 52, 43 & 62 percentage respectively.

Conclusions: Most respondents exhibited a healthy attitude and a fairly sound knowledge, except for their perception of risk associated with individual drugs which was much higher than what is mentioned in the literature. Educational interventions may help to increase the awareness leading to better and confident prescribing.


Prescribing, Medication, Pregnancy, Medical practitioners

Full Text:



Yankowitz J, Niebyl JR. Drug Therapy in Pregnancy. 3rd ed. USA: Lippincott Williams & Wilkins; 2001

Sharma R, Kapoor B, Verma U. Drug utilization pattern during pregnancy in North India. Indian J Med Sci. 2006;60:277-87.

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Teratology and medications that affect the Fetus. In Williams Obstetrics. 23rd edn. U.S.A: McGraw-Hill. 2011.

Banhidy F, Lowry RB, Czeizel AE. Risk and benefit of drug use during pregnancy. Int J Med Sci. 2005;2:100-6.

Yawn B, Knudtson M. Treating asthma and comorbid allergic rhinitis in pregnancy. J Am Board Fam Med. 2007;20:289-98.

Damase-Michel C, Pichereau J, Pathak A, Lacroix I, Montastruc JL. Perception of teratogenic and foetotoxic risk by health professionals: a survey in midi-pyrenees area. Pharmacy Practice. 2008;6:15-9.

Chin RKH, Lao TTH, Chang AMZ. Drug prescribing in pregnancy - a survey among general practitioners in Shatin. J Hong Kong Med Assoc. 1986;38:27-9.

Ratnapalan S, Bona N, Chandra K, Koren G. Physicians’ perceptions of teratogenic risk associated with radiography and ct during early pregnancy. AJR. 2004;182:1107-9.

Schaefer C. Drug safety in pregnancy: Utopia or achievable prospect? Risk information, risk research and advocacy in teratology information services. Congenital Anomalies. 2011;51:6-11.

Chambers CD, Polifka JF, Friedman JM. Drug Safety in pregnant women and their babies: ignorance not bliss. Clin Pharmacol Therap. 2008;83:181-3.

Meadows M. Pregnancy and the drug dilemma. FDA consumer magazine. US Food and Drug Administration. 2001.

Peters PWJ. Risk assessment of drug use in pregnancy: prevention of birth defects. Ann Ist Super. Sanita. 1993;29:131-7.

Goodwin J, Rieder S, Rieder MJ, Matsui D. Counseling regarding pregnancy-related drug exposures by family physicians in Ontario. Can J Clin Pharmacol. 2007;14:e58-69.

Koren G, Levichek Z. The teratogenicity of drugs for nausea and vomiting of pregnancy: perceived versus true risk. AmJ Obstet Gynecol. 2002;186:248-52.

Einarson A, Park A, Koren G. How physicians perceive and utilize information from a teratogen information service: the mother risk program. BMC Med Edu. 2004;4:6.