Analysis of Analgesic Medicines Information Queries in Pregnancy and Breastfeeding

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Abstract

(1) Background: Access to reliable medicines information is essential to support safe medi-cine use during pregnancy and breastfeeding, where concerns regarding fetal and neonatal safety complicate clinical decision-making. Analgesics are widely used during these peri-ods, yet uncertainty regarding safety persists due to evolving evidence, regulatory changes, and inconsistent information sources. Obstetric medicines information services play a critical role in addressing these information needs. This study aimed to evaluate patterns and characteristics of analgesic-related enquiries to a specialist obstetric medicines infor-mation service over a 20-year period. (2) Methods: A retrospective observational study was conducted using enquiry data from the King Ed-ward Memorial Hospital Obstetric Medicines Information Service (KEMH OMIS), Western Australia. All enquiries recorded between 1 January 2001 and 31 December 2020 were ex-tracted from the Microsoft Access® database. Records with incomplete data were excluded. Data were standardised, coded, and analysed using Microsoft Excel® and SPSS® Version 25. Descriptive statistics were used to summarise enquiry characteristics, caller type, tim-ing of exposure, and analgesic medicines involved. Trends over time were analysed. (3) Results: A total of 48,458 enquiries were analysed, of which 4,978 (10.3%) related to anal-gesics, making this the third most common medicine class. Most enquiries related to breastfeeding (62.1%), followed by pregnancy (32.7%). The public accounted for 60.9% of calls, while health professionals contributed 39.1%. The highest frequency of breastfeeding enquiries occurred within the first four weeks postpartum, and pregnancy enquiries were most common in the second trimester. Paracetamol was the most frequently enquired an-algesic (24.5%), followed by codeine (19.8%), ibuprofen (14.4%), diclofenac (7.2%), and tramadol (9.3%). Analgesic-related enquiries declined significantly over time (p< 0.001), particularly codeine-related enquiries following regulatory safety warnings. (4) Conclusion: Analgesics represent a substantial proportion of medicines information enquiries in preg-nancy and breastfeeding, reflecting widespread use and ongoing safety concerns. Pharma-cist-led medicines information services play a critical role in supporting safe analgesic use. Continued surveillance and targeted education are essential to optimise maternal and in-fant medication safety.

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