The PEGASUS project--a prospective cohort study for the investigation of drug use in pregnancy. PEGASUS Study Group.

Since the thalidomide disaster, it is well accepted that drugs can have adverse effects on the developing human being. Although numerous studies show that medication during pregnancy is wide-spread, there still is a serious lack of comprehensive and valid data concerning the risks of drug use during pregnancy. One objective of the PEGASUS project, a population-based cohort study focusing on Munich, is to prospectively record information on drug exposure during pregnancy, to evaluate these data with regard to teratogenic properties, and to contribute to the quality assurance of medical treatment in pregnancy. The results of PEGASUS confirm that drug utilization during pregnancy is rather common--84% of the women use at least one preparation. The most frequent groups are minerals (mainly magnesium), iodide, and iron preparations. Although randomized studies have shown that periconceptional folic acid supplementation considerably reduces the risk of neural tube defects, only very few women in the PEGASUS project recorded folic acid intake during the critical period and in sufficient dosage. Moreover, only 42% of the pregnant women apply iodide prophylaxis in the recommended dosage.