Results from a cohort study evaluating over one million pregnant women enrolled in Medicaid revealed that nitrofurantoin was the most commonly dispensed medication during pregnancy. Findings from the analysis are published in Obstetrics & Gynecology.

Researchers analyzed the 2006–2007 Medicaid Analytic eXtract data to identify the 20 most common and 10 most common prescription drugs classified as Categories D or X dispensed to pregnant women with live births (n=1,106,757). Outpatient pharmacy records were used to record medication dispensings and the proportion of pregnancies that were dispensed ≥1 prescription medication.

Among the pregnant women, 82.5% were dispensed ≥1 prescription medication. The most commonly dispensed drugs during pregnancy were: nitrofurantoin (21.6%), metronidazole (19.4%), amoxicillin (18.0%), azithromycin (16.9%), and promethazine (13.5%).

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More younger women (age <20 years) were given nitrofurantoin, metronidazole, and azithromycin than older women (age ≥35). Also, metronidazole was more commonly dispensed among black women vs. white women (29.8% vs. 14.4%; prevalence ratio 2.07, CI: 2.05–2.09); otherwise, proportions were higher among white women. A total of 42% of women had at least one dispensing for a Category D or X medication during pregnancy, not including fertility treatments. Of the Category D medications, codeine (11.9%) and hydrocodone (10.2%) were the most common.

Study findings show that anti-infectives were the most commonly dispensed prescription medications. Maternal age and race-ethnicity showed further variations in the commonly dispensed prescriptions.

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