The Centers for Disease Control and Prevention (CDC) reports that three-quarters of health care efforts in the U.S. go toward the stabilization of chronic diseases. These persistent conditions are often the leading cause of death and disability. Though there are usually medications available to manage chronic ailments, they are not always safe for use by all.

In particular, these life-saving drugs can have potentially dangerous effects on unborn children. The problem, though, is that not enough research has been done on the issue — pregant women are essentially blindly making the decision whether or not to keep taking their meds.

And because mothers tend to be — understandably — overly concerned with the well being of their children, they will often risk their own health along the way. As a result, the rate of maternal deaths has doubled in the past twenty years, as mothers will stop taking medications whose benefits often outweigh the drawbacks.

It has been estimated that about 10 percent of mothers-to-be suffer from chronic medical conditions. These include, but are not limited to, mental health disorders, heart conditions, elevated cholesterol, urinary tract infections (UTIs) and obesity. While some drugs have clear side-effects on children born to mothers who use them — such as the anticonvulsant for epileptics, Valproate — others have simply not been tested for use in pregnant women. Drug trials aimed at pregnant women are very rare, according to a new Drug and Therapeutics Bulletin in the British Medical Journal. This study looked at treatments for UTIs, chronic obstructive pulmonary disease (COPD) and psychosis, in order to provide more information about their general safety and their safety for expecting mothers who wish to stop using them.

Mental Health

Regarding drugs for mental health disorders, researchers have found that when a woman only has mild symptoms of mental disorders, it can be safe for her to stop using her medications slowly. There are few immediate withdrawal symptoms and after three months, patients with mild mental disorders were still healthy.

However, in groups where women were severely mentally disturbed, their behavior deteriorated increasingly during and after drug withdrawal. There was a significant increase in death after three years of being without their drugs that is difficult ignore — which may have added to the doubling of maternal death over the last two decades.

COPD

COPD refers to diseases that create blockages of airflow and breathing issues such as emphysema or asthma. Medications for these issues include glycopyrronium, a type of muscle relaxant that relaxes the lungs so that air can enter. The drug is inhaled and helps those with impaired lung function breathe. In a study that reduced dosages in COPD patients, researchers found that the quality of life decreased in those with severe COPD, often caused by smoking. However, the side effects of the drug's use are nearly a dangerous as ceasing its use: these include kidney failure, heart failure, and blindness. Given these side effects, it is understandable why mothers-to-be would stop their use of glycopyrronium; however, when benefits, such as the life of the mother, outweigh risks, like potential blindness or organ failure, most doctors would recommend that patients remain on life-saving drugs.

UTIs

Women have greater risk of developing UTIs than men, the Mayo Clinic reports. If left untreated, a urinary tract infection may spread to the kidneys, as it can affect any part of the urinary system, including the bladder, kidneys, urethra and ureters. UTIs may occur frequently or infrequently, based on hygiene and history of sexually transmitted infections (STIs). A woman with frequent infections may need to use antibiotics for a longer period of time. If this woman is expecting to have a child, treatment of the infection is vital to both her and her child's health, as vaginal infections can cause miscarriages if left untreated and allowed to spread. Overuse of antibiotics however can lead to bacterial resistance and more dangerous infections in those with frequent UTIs. Many home remedies exist for this, and are not harmful to developing fetuses, as they are simply changes in diet like the drinking of cranberry juice, use of probiotics and acupuncture.

Final Word

A mother's decision regarding her medication use during pregnancy is often a difficult decision to make. Many chronic disorders require the use of medications to ensure the mother's health, but may put a baby's health at risk. Decisions regarding cessation should be left to doctors who can weight benefits over risks and determine what is best or even provide natural alternatives for the management of chronic diseases.

Source: Drug and Therapeutics Bulletin: The Independednt Review of Medical Treatment. Volume 51, Number 6. BMJ. 2013.

Published by Medicaldaily.com