Women living with chronic diseases are particularly affected, as they may require ongoing medication to manage their health. But the lack of research or regulatory clarity means healthcare professionals do not have enough evidence on the use of medication before and during pregnancy. This leads to clinical decisions being based largely on precaution and anecdotal evidence.
There is a tendency to view treatment as potentially harmful to the fetus, but risk is relative: leaving a disease untreated may cause harm to the woman, the unborn child or to both of them. This dilemma may lead healthcare professionals to give conflicting information, leaving women feeling that they must choose between managing their disease and having a child.
Despite the lack of evidence, almost half of pregnant women will take at least one medication over the course of their pregnancy. Recent years have seen some progress in research around medical treatment in pregnancy, and it is now time for clinical practice to follow.
All stakeholders must work together to shift mindsets, revise ethical and regulatory frameworks and create innovative partnerships to collect evidence to guide clinical care that will align with women’s fertility goals.
Dr Anne Lyerly, US
HPP worked with a group of experts from across Europe and the US to develop a policy report on achieving optimal care for women of childbearing age who are living with a chronic disease. We identified four pillars of action required to improve care for this group of women:
The report details the actions required within each pillar to break the cycle of lack of information around medication use in pregnancy and start providing optimal, evidence-based care for all women.
We are grateful to the following experts for sharing their knowledge in interviews and providing comments to a working draft:
The work was proposed and financially supported by UCB. The opinions and conclusions expressed or implied in the report are those of the authors and/or quoted experts, and do not necessarily reflect those of UCB. The material has undergone a courtesy review by UCB.
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