Facts | Treating for Two | Medications and Pregnancy

Facts | Treating for Two | Medications and Pregnancy

Woman talking with her doctor about medication use

CDC’s Treating for Two Initiative is aimed at providing better information to women and their healthcare providers about medication use during pregnancy. 

Medication Use in Pregnancy: A Public Health Concern

• Medication use has surged to 90% of all pregnant women. About 70% take at least one prescription medicine. Over the last 30 years, use of prescription medicine during the first trimester of pregnancy has increased more than 60%.1
• One in every 33 babies born in the United States is born with a birth defect. We know that taking certain medications during pregnancy can cause serious birth defects. Examples are thalidomide (also known as Thalamid®) and isotretinoin (also known as Accutane®).
• But, there are also unknown risks to the pregnant woman and baby. Because pregnant women are often excluded from clinical trials, there is limited information on the effects of taking medications during pregnancy. A 2011 study found that only 9% of medications approved by the U.S. Food and Drug Administration (FDA) from 1980 through 2010 had adequate data to determine their risk for birth defects. Only about 2% of medications approved by the FDA from 2000 through 2010 had sufficient data to characterize this risk.2

CDC Activities

CDC is working with other federal agencies, non-federal partners, and the public to build a comprehensive approach to improve the quality of data on the effects of using medicine during pregnancy. CDC’s focus on medications in pregnancy is an initiative called Treating for Two: Safer Medication Use in Pregnancy.

The Treating for Two Initiative aims to:

• Better inform medical treatment decisions for women who are pregnant or could become pregnant
• Improve women’s health by identifying the best treatment options for common conditions before and during pregnancy
• Protect fetal and infant health by minimizing exposures to potentially harmful medications

To reach these goals, the Treating for Two Initiative will follow this approach:

• Expand research: CDC monitors national trends in medication use over time to determine priorities for medication safety research. CDC researchers then investigate commonly used medications to identify possible links to birth defects.
• Evaluate evidence: CDC proposes an expert review process to compare the available treatment options for common health conditions (e.g., depression, asthma) to identify the safer option(s) for use during pregnancy.
• Educate: Summary guidance from the expert review would provide credible and reliable information to assist women and their healthcare providers in making informed treatment decisions during pregnancy.

References

1. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S, National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol. 2011;205(1):51.e1-8.
2. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet Part C. 2011;157:175-82.