Non-prescribed drug use and predictors among pregnant women in Ethiopia: systematic review and meta-analysis

Abstract

Background: The use of non-prescribed drugs are common to pregnant women. It may lead to undesirable effects, such as birth defects. Study results on the occurrence and predictor of non-prescribed drug use among pregnant women throughout Ethiopia are highly variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of non-prescribed drug use and predictors among pregnant women in Ethiopia. Methods: We systematically searched studies from the international databases, including PubMed, EMBASE, Web of Science, Science Direct, Google Scholar, the Cochrane Library and others. The meta-analysis was conducted using Stata15. I 2 test and Egger's test were used to assess the heterogeneity and publication bias respectively. The random-effect model was used to estimate the pooled prevalence of non-prescribed drug use at a 95% CI. Results: Eleven studies with a total of 4492 pregnant women fulfilled the inclusion criteria and were included. The pooled national level non-prescribed drug use among pregnant women was 30.38% (95% CI: 20.28, 40.48). The highest use of non-prescribed drug among pregnant women was observed in Amhara region 36.71%, while the lowest was in Tigray region 9.67%, respectively. The most frequently consumed non prescribed drugs by pregnant mothers were paracetamol 34.38%, amoxicillin 14.73%, aspirin 4.25%, metronidazole 2.81% and ciprofloxacin 2.80%. Maternal previous history of self-medication, maternal illness during pregnancy and maternal marital status were significantly associated with women non-prescribed drug use during pregnancy. Conclusions: The overall prevalence of non-prescribed drug use among pregnant women in Ethiopia is relatively high, and varies across different regions. The most frequently consumed non-prescribed drug by pregnant mothers was paracetamol. Maternal; previous history of selfmedication, illness during pregnancy and marital status were significantly associated with pregnant women non-prescribed drug use. Awareness of the possible side effects of taking nonprescribed drugs for all pregnant women is very relevant in the media and in the maternity ward. In particular, it is important to make clear to mothers who have a history of self-medication, to those who have a history of illness during pregnancy and to those who are pregnant, unmarried or divorced.

The use of medicinal plants by pregnant women in Africa: A systematic review

“…In consonance with many previous studies [126] it is concerning that antimicrobials are among the top three groups of medicines used for self-medication in this study (Paper III). Furthermore, antimicrobials were irrationally used and gave rise to MRPs in the inpatient setting (Paper IV).…”

“…On the other hand, the study findings showed that the majority of women admitted to the hospital (85.2%) used one or more prescription or non-prescription medicines (excluding vaccinations) prior to hospitalization. In line with previous studies from other geographical areas of Ethiopia [126], most of the pharmaceutical medicines used for self-medication were analgesics (Paper III) for the relief of pain or inflammation. This is corroborated by previous findings that Ethiopians employ self-medication for illnesses that are perceived as mild [34,42].…”

“…It is reassuring that most of the conventional medicines used (prescribed or self-medicated) were probably safe to use during pregnancy because the majority are either supplements, analgesics or safer antimicrobials (Papers III, IV). This is corroborated by outpatient studies from different areas of Ethiopia [126,150], indicating that there is similar pattern of medicine use in pregnancy across the country. However, some women carrying a child were selfmedicating with potentially risky medicines (Paper III) necessitating recommendations for cautious use, sticking to standard prescribing and dispensing guidelines and appropriate educational interventions.…”

“…Maternal and child health is one of the main concerns of Ethiopia [102,126]. With the aim of reducing the high maternal death rate, the country executed a set of high impact interventions such as antenatal care (ANC), skilled birth services and postnatal care [102].…”

Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis

“…Stata, version 15.1 (StataCorp. ), was utilized to collect data and to perform relevant analyses in this meta-analysis (Gebrie et al, 2019;Adane et al, 2020). Each numerical value of the result was presented with a 95% confidence interval (95% CI).…”