Medication Used in Pregnancy

 

Payal Sonawane, Aishwarya Tare, Prerna Tarak, Dr. Nilima N. Khakal*,

Dr. S. S. Angadi

 

Yash Institute of Pharmacy, Ch. Sambhajinagar-431001, Maharashtra, India

 

*Correspondence: nilam.khakal@gmail.com;

DOI: https://doi.org/10.71431/IJRPAS.2025.41004  

Article Information		Abstract
Review Article Received: 18/10/2025 Accepted: 24/10/2025 Published: 31/10/2025   Keywords Pregnancy; Medications; Teratogenicity; Pharmacotherapy; Aspirin; AI in Healthcare		Pregnancy-related medication use is widespread, but it can be clinically challenging because of physiological changes, altered drug metabolism, and a lack of safety data. This research focuses on India and looks at teratogenic risks, pharmacological considerations, and common drug classes used during pregnancy. The high prevalence of essential supplements (92%) and low-dose aspirin (90%) in Sambhajinagar, as reported by a community-based survey, indicates adherence to current pre-eclampsia prevention guidelines. New digital solutions are enhancing medication safety, counseling, and monitoring, especially in rural and low-resource settings. Examples of these include artificial intelligence (AI) and mobile health (mHealth) platforms like GynoSakhi, mMitra, and SwasthGarbh.One possible approach to providing holistic maternal care is the combination of evidence-based medication and traditional Ayurvedic treatments. Pregnant women must be ethically included in clinical trials, digital tools must be validated, and continuous research is necessary to ensure safe, customized care.

 

INTRODUCTION

A growing fetus causes a number of changes in a woman's organs and tissues during pregnancy. It takes an average of 266–270 days, or roughly nine months, from fertilization to delivery. Understanding the effects of pharmacotherapy in this population is crucial because of the physiological changes that occur during pregnancy and the possibility of drug transfer across the placenta [1]. Nearly 95% of expectant mothers worldwide take at least one medication, making the use of pharmaceutical treatments during pregnancy both common and clinically complex [2]. Because pregnant women are routinely excluded from clinical trials, there are still few reliable safety data for many medications despite their high prevalence [3]. Due to the lack of evidence, medical professionals are in a challenging position where they must make treatment decisions with little direction and frequently balance the risks of ineffective therapy against the possibility of fetal harm.

Pharmacological Considerations in Pregnancy

Physiological Changes in Pregnancy and Their Implications for drug Therapy

The physiological changes brought on by pregnancy have a significant impact on the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs. Lower plasma concentrations are frequently the result of cardiovascular changes, such as increased cardiac output and blood volume, which broadens the distribution volume for hydrophilic medications. The removal of medications that the kidneys have cleared is accelerated by improved renal function, especially an increased glomerular filtration rate. Hepatic metabolism is also affected, as drug biotransformation is influenced by the fluctuating regulation of cytochrome P450 (CYP) enzymes. Drug absorption may be impacted by changes in the gastrointestinal tract, such as decreased motility and slowed gastric emptying, while a higher free fraction of protein-bound medications is the consequence of lower plasma albumin levels [4]. Changes in hormone levels during pregnancy can also modify receptor sensitivity, changing pharmacodynamic reactions. Customizing pharmacologic interventions to protect fetal development and maternal health requires an understanding of these trimester-specific changes [5].:

Placental Transfer and Fetal Exposure

The placenta facilitates the exchange of necessary substances and some xenobiotics, such as medications, by acting as a semi-permeable interface between the fetal and maternal circulations [2]. Although passive diffusion is the most common way for drugs to pass through the placental barrier, depending on the physicochemical properties of the drug, other mechanisms like facilitated transport, active uptake, and vesicular processes may also play a role [6].

Lipid solubility: Lipophilic substances move through the placental membrane more quickly than hydrophilic ones [2].

Ionization and pH gradient: pH-dependent ion trapping can cause weak bases to build up in the fetal compartment [2]

Protein binding affinity: A drug's free fraction available for transfer is reduced when it is heavily bound to maternal plasma proteins [4].

Enzymatic activity in the placenta: Before drugs reach the fetus, their concentrations can be changed by metabolic enzymes like esterases and CYP450 isoforms [3].

Early pregnancy: Because of organogenesis, fetal tissues are extremely sensitive during this time, but the placental barrier is less permeable. Drug transfer is improved in later stages by increased placental perfusion, although fetal vulnerability may vary.

The level of fetal drug exposure is determined by these factors taken together, and the results can range from neonatal complications to developmental toxicity. Making treatment decisions that put the safety of the fetus and the health of the mother first requires a sophisticated understanding of placental pharmacokinetics.

2.3 Commonly Used Drug Classes During Pregnancy

For chronic conditions, gestational complications, or regular supplementation, pharmacological intervention is frequently required during pregnancy. The benefits to the mother must be carefully weighed against any possible risks to the fetus when choosing the right drugs.

Table 1: Commonly Used Drug Classes during Pregnancy

Drug Class	Examples	Safety Considerations
Analgesics & Antipyretics	Paracetamol, Ibuprofen, Aspirin	Paracetamol is widely regarded as safe. NSAIDs should be avoided in late pregnancy due to risk of premature closure of the ductus arteriosus.
Antibiotics	Penicillin, Cephalosporins, Erythromycin, Metronidazole	Beta-lactams are generally safe. Tetracyclines are contraindicated due to adverse effects on fetal bone and teeth development.
Vitamins & Supplements	Folic acid, Iron, Calcium, Vitamin D	Essential for maternal and fetal health. Folic acid supplementation is critical for neural tube defect prevention.
Antihypertensives	Methyldopa, Labetalol, Nifedipine	Methyldopa and labetalol are preferred. ACE inhibitors and ARBs are contraindicated due to teratogenic potential.
Antidiabetic Agents	Insulin, Metformin	Insulin is the first-line therapy. Metformin may be used with caution. Glycemic control is vital throughout pregnancy.
Antiepileptics (AEDs)	Lamotrigine, Levetiracetam, Valproate	Monotherapy is preferred. Valproate carries a high risk of teratogenicity and should be avoided if possible.
Antiemetics	Doxylamine-pyridoxine, Ondansetron	Generally considered safe. Ondansetron use should be monitored due to rare associations with congenital anomalies.
Thyroid Hormones	Levothyroxine	Safe and necessary for maintaining maternal and fetal thyroid function. Dose adjustments may be required during pregnancy.
Asthma Medications	Budesonide (inhaled corticosteroid), Salbutamol (beta-agonist)	Inhaled therapies are preferred. Maintaining adequate maternal oxygenation is crucial to prevent fetal hypoxia

 

Teratogenicity and Critical Periods of Fetal Develpoment

Teratogenicity is the possibility that specific medications, substances, or environmental exposures will interfere with a fetus's normal development and cause structural abnormalities or functional impairments. The dosage, length of exposure, maternal physiology, and—most importantly—the time during pregnancy all affect the severity and type of these effects.

Vulnerability Particular to Trimesters

Weeks 1–12 of the First Trimester Because it includes organogenesis, this stage is the most susceptible to teratogenic insults. Significant congenital abnormalities like cardiac defects, neural tube defects, and limb abnormalities can result from exposure during this window [2].

Weeks 13–26 of the Second Trimester distinguished by quick tissue differentiation and fetal growth. Growth restriction, slight structural abnormalities, or functional disruptions can be the outcome of teratogenic exposure [3].

Weeks 27–40 of the Third Trimester The development of the organs and the body becomes the main focus. Instead of causing severe structural defects, teratogens at this stage are more likely to result in neurodevelopmental problems, functional deficits, or neonatal toxicity [4].

Teratogenic agent examples

Critical Exposure, Drug, and Related Defects Window

Limb deformities, Thalidomide, four to eight weeks

Isotretinoin, 2–5 weeks of craniofacial, cardiac, and central nervous system abnormalities
The drug warfarin Abnormalities of the skeletal system and central nervous system, 6–12 weeks ACE Inhibitors fetal growth restriction and renal dysplasia, The second and third trimesters.
Crucial Clinical Findings

Organ formation during the first trimester increases the risk of structural teratogenic effects.
The length of exposure and the dosage are important factors that affect the fetal outcome.
When taken as prescribed, many drugs are safe, highlighting the significance of a personalized risk assessment.
Limitations of the Evidence and Ethical Issues in Prescription During Pregnancy
Pregnancy-related pharmacologic management poses unique difficulties in terms of ethical decision-making and the availability of evidence. Pregnant women frequently use medications, but because of worries about fetal safety, they are usually left out of clinical trials. As a result, doctors frequently have to make decisions based on incomplete information from observational studies, animal models, or post-marketing surveillance.

Gaps in the evidence

Clinical Trial Scarcity: The majority of medications lack reliable data from randomized controlled trials that are tailored to pregnant patients.

Safety profiles that are not complete: The long-term consequences are still not well understood, especially the neurodevelopmental and subtle teratogenic effects.

Uncertainty in Dosage: Although there are few trimester-specific dosing recommendations, physiological changes during pregnancy affect drug metabolism and distribution.

Inadequate Interaction Data: It is frequently impossible to find information on drug-drug interactions in relation to pregnancy physiology.

2.8 Difficulties in Ethics

Complex Consent Dynamics Informed consent entails balancing the potential risk to the fetus against the benefit to the mother, frequently without clear information.
Risk-benefit ambiguity: Physicians must make complex choices based on insufficient data, occasionally extrapolated from populations that are not pregnant.
Research Equity: Inequalities in access to evidence-based care are sustained when pregnant women are routinely excluded from trials.
Dual-Person Ethical Dilemmas: These come up when fetal development may be at risk while maternal treatment is necessary, necessitating careful ethical consideration.

New Developments

Registries for Pregnancy Exposure Nowadays, longitudinal data on maternal drug use and fetal outcomes are gathered by large observational databases, providing practical insights in situations where randomized trials are not feasible.

Research on Pharmacokinetic and Pharmacodynamic More precise dosing plans suited to particular trimesters have been made possible by a better understanding of the physiological changes that occur during pregnancy.
Studies of Placental Transport Better predictions of fetal drug exposure and safer drug design are being guided by research into placental transporter proteins and metabolic pathways.
Predictive Analytics and Big Data Risk stratification and post-marketing surveillance are being advanced through the integration of machine learning models with electronic health records.
Regulatory Changes Detailed, evidence-based narratives are now given precedence over categorical labels under the FDA's Pregnancy and Lactation Labeling Rule (PLLR) and other international initiatives.

Prospective Paths

Clinical Trial Ethical Inclusion To produce high-quality, population-specific data, carefully planned studies with pregnant participants are necessary.

Techniques in Precision Medicine Customized treatments based on maternal and fetal genetic traits may be made possible by pharmacogenomic profiling.

Creative Methods of Drug Delivery The goal of research on controlled-release and targeted formulations is to minimize fetal exposure while maximizing maternal efficacy.

Studies of Longitudinal Results Research on long-term child health outcomes, such as neurodevelopment and the risk of chronic diseases, after in utero drug exposure is becoming more and more important.
Global Cooperation and Information Exchange In order to address regional disparities and inform universal guidelines, international partnerships and harmonized data platforms can be useful.

MATERIAL AND METHODS

The pattern of medication use among pregnant women was evaluated in the local area (ch. Sambhajinagar) through a community-based survey. The research design was descriptive and cross-sectional.

Study Population  

After gaining verbal consent, pregnant women who lived in the neighborhood were added. To learn about common pregnancy medications, a survey of women in all trimesters was conducted.

Data Collection

A structured questionnaire covering demographic information, prescription medication use, supplement use, and knowledge of drug safety during pregnancy was used to gather data. Manual compilation of responses was done, and when possible, prescription records were consulted for verification.

Data Analysis

The percentage of women receiving various drug classes was ascertained by analyzing the gathered data using a straightforward percentage distribution. These outcomes were attained:

Aspirin – 90% of women

Pain relievers (analgesics) – 8.5%

Vitamins and supplements (calcium, iron, folic acid) – 92%

Ayurvedic Preparation-2.5%

Antiemetics: 20%

Other medications – 40%

The data were represented graphically for better visualization.

Figure. 1: Medication used in pregnancy (Survey Data)

Increasing Aspirin Use in Pregnancy

 Pregnant women, especially those who are deemed to be at high risk for pre-eclampsia or other hypertensive disorders, are using low-dose aspirin at a noticeably higher rate as a result of recent guidelines and new evidence [7]. This trend in our community is reflected in the survey's finding that 90% of women take aspirin.

Why  Increase?

Figure. 2: timeline of Evidence and Guidelines for Low-Dose Aspirin (LDL) in Pregnancy (up to 2025)

1. Guidelines for Recommendations

Prominent obstetric organizations, like the American College of Obstetricians and Gynecologists (ACOG), advise pregnant women who are at high risk of pre-eclampsia to begin taking low-dose aspirin (≈ 60-150 mg/day, typically 81 mg) between weeks 12 and 28 (ideally before 16 weeks) and continue taking it until delivery [18].

Data from LMICs (low- and middle-income countries)

Research conducted in LMIC environments, such as those in India, demonstrates that low-dose aspirin is comparatively safe and effective in lowering the risk of preterm birth, pre-eclampsia, and associated complications without appreciably increasing the risk of serious side effects [19]. For instance, daily low-dose aspirin starting in early pregnancy was found to be well tolerated in a large study conducted in LMICs, which included India among other nations.

Adaptations to Local Clinical Practice

Obstetricians are increasingly recommending aspirin prophylaxis for women with risk factors, such as a history of hypertension, pre-eclampsia, chronic kidney disease, or other moderate risk factors, as awareness of the preventive benefits of aspirin grows [20] This probably helps explain our local study's high percentage of 90%.

 

Safety Considerations

When taken as directed by a physician and at recommended dosages (between 60 and 150 mg per day), low-dose aspirin is usually regarded as safe [17].

Evidence has not shown a significant negative impact on fetal outcomes when used in the first and second trimesters in accordance with guidelines [16].

Proper indication, dosage, and timing are crucial because higher "analgesic" doses of aspirin, particularly later in pregnancy, are linked to risks (such as increased bleeding, effects on fetal platelet function, or ductus arteriosus).

Implications of our findings:

Aspirin use is very common in our community, as indicated by the 90% of pregnant women who responded to our survey. While there may be advantages (less pre-eclampsia, possibly fewer preterm births or low birth weights), this also emphasizes the necessity of:

Making sure prescriptions are appropriate in terms of dosage, risk assessment, and timing

keeping an eye out for contraindications (such as GI ulcers or bleeding disorders)

Teaching women about potential risks, when to begin, when to stop, or consulting with doctors Monitoring maternal and neonatal outcomes through local studies linked to this high aspirin use rate.

AI and mHealth Tools for Pregnancy and Medication Safety in India

Pregnancy care, medication safety, and counseling are being revolutionized in India by a number of artificial intelligence (AI) and mobile health (mHealth) technologies [21]. These platforms assist pregnant women, particularly in rural and regional language contexts, by using chatbots, reminders, and data-driven monitoring [8].

Important Examples:

Medication Safety Tool/App with Essential Features for Counseling and Regional/Language Support

GynoSakhi

A platform driven by AI and IoT that provides virtual health assistants around-the-clock, medication reminders, home vitals monitoring, including blood pressure and glucose, and alerts for risk factors that need medical review. Both urban and rural regions use a variety of Indian languages [23].

Sakhi Health  

chatbot that offers validated prenatal care information, medication reminders, and ways to get in touch with medical professionals. Available through NGO programs in Bengali, Marathi, Hindi, and other languages [24].

Stree Pregnancy Chat App

Women can use a conversational app to understand symptoms, interpret prescriptions, and find safe medication practices. regional usage in Indian cities.

 

SwasthGarbh (IIT Roorkee & AIIMS Delhi)

An Android app that monitors pregnancy tests, provides warnings for abnormal results, and helps with safe treatment plan counseling. The multilingual interface was created for India [25].

Cartula Janani

offers video consultations, daily iron and folic acid supplement reminders, and data-driven coaching. Six to seven Indian languages are supported.

Suman Sakhi (MP NHM Chatbot)

An AI chatbot built on WhatsApp that provides accurate information about pregnancy, medications, and warning signs. Hindi; used throughout the Madhya Pradesh state.

RAKSHA Health Chatbot

AI chatbot that fights false information by providing validated pregnancy and medication safety information. Bengali, Punjabi, Gujarati, Nepali, English, and Hindi.

Maatritva

An Indian focus on the use of mHealth platforms by midwives to monitor high-risk pregnancies and the role of AI tools and apps in medication use, counseling, and pregnancy.

                    

  Figure. 3: Sakhi Health                                                  Figure.4: Stree Pregnancy Chat App

 

                                               

                        Figure.5: Cartula Janani                              Figure.6: Suman Sakhi (MP NHM Chatbot) 

Throughout India, mobile health (mHealth) and artificial intelligence (AI) platforms are being used more and more to promote safer medication use, enhance counseling, and close gaps in prenatal care, particularly in areas with limited access to specialists. Here is a brief, ready-to-use section that you can include in your article (complete with references and examples from India).

 

 

Role of AI tools & apps in medication use, counselling and safety during pregnancy — an India focus   

In India, mobile health (mHealth) and artificial intelligence (AI) platforms are being used more and more to boost safer medication use, enhance counseling, and fill in the gaps in prenatal care, particularly in areas with limited access to specialists. You can use the brief, ready-to-use section below in your article (complete with Indian examples and references).

How AI/mHealth help with medication decisions and counselling in India

In India, telemedicine and AI-augmented apps are being used to: (1) provide pregnant women with personalized, timed information; (2) allow remote clinician counseling and prescription review; (3) alert frontline staff to possible drug-disease or drug-drug interactions; and (4) risk-stratify patients so that prescriptions (or referrals) are given priority to those who will benefit from them. Numerous Indian states have already seen improvements in maternal knowledge and service uptake as a result of large voice-message and mobile programs like mMitra. This shows how digital channels can be used to provide medication-related counseling on a large scale.

Examples specific to India

mMitra ( ARMMAN)

a scaled voice-message mHealth program that enhanced maternal care behaviors and knowledge; it shows how digital counseling can help with medication adherence and appropriate care-seeking [26].

2. mMitra ( ARMMAN) (e.g., Motherhood One)-

AI assistants and paid pregnancy apps have been introduced by Indian startups and hospital networks. These platforms provide personalized reminders, round-the-clock pregnancy advice, and clinician escalation pathways. Medication reminders, interaction alerts, and triage recommendations are also starting to be included.

                    

             Figure.7: mMitra ( ARMMAN)                                        Figure.8: mMitra ( ARMMAN)

Al for community health workers:

To improve safe prescribing in low-resource settings, pilots incorporating AI decision-support into platforms used by ASHA/ANM employees seek to assist in identifying high-risk pregnancies and directing when medication (for example, for hypertensive disorders, anemia, or GDM) or referral is required.

Telemedicine and remote prescription review:

In India, access to obstetric advice and remote prescription review has expanded due to the quick growth of teleconsultation, which was accelerated during COVID-19. Studies on telemedicine conducted in Indian centers demonstrate high patient satisfaction and suggest that, when combined with local referral pathways, teleconsultation can safely support medication counseling and prenatal follow-up.

Policy, safety and Implementation context in India:

Pregnancy medication decisions are still based on national treatment guidelines and program documents (such as the Standard Treatment Guidelines and NHM materials); for AI tools to be clinically beneficial, they must be in line with these guidelines and local formularies. A significant step toward safer medication use at scale is being taken at the same time by professional bodies and foundations in India partnering to gather real-world pregnancy data and train AI tools for maternal risk stratification.

Challenges specific to India:

Data gaps and external validation: Reliability is limited because many models have not yet been validated on Indian pregnancy cohorts.

Digital divide: Voice-based programs (such as mMitra) are frequently more inclusive; reach is limited by rural connectivity, literacy, and smartphone access.

Regulation and acceptance by clinicians: Tools must be transparent and auditable in order to gain the trust of clinicians and adhere to Indian clinical standards.

Useful advice for India (for policymakers, program designers, and clinicians)

Make integrating AI tools with local drug formularies and national treatment guidelines a top priority.

2. To reach rural and low-literate users, use voice and basic SMS channels in addition to apps (mMitra evidence).

3. Prior to clinical deployment, validate models using Indian datasets and publish external validations.

4. Develop workflows for clinicians that retain the provider's ultimate prescription decision, utilizing AI only as a supplement to draw attention to interactions, risks, or other options.

Gap Identified:

Insufficient attention is paid to medication safety during specific trimesters and drug-drug interactions.

In some states, regional language coverage is still lacking.

Large-scale clinical studies for medication outcomes have not yet validated the majority of tools.

Women without smartphones or internet access continue to face accessibility challenges.

Talking In order to balance the therapeutic needs of the mother with the safety of the fetus, the use of medications during pregnancy poses a clinical and ethical challenge. Trimester-specific dosage adjustments are required due to physiological changes, including increased plasma volume, altered hepatic metabolism, and changes in renal clearance. Because pregnant women are excluded from clinical trials, most safety profiles are extrapolated from animal data or post-marketing surveillance, despite the fact that drugs are frequently used during pregnancy.

Our community-based survey reveals that 90% of people use low-dose aspirin, which is indicative of the increasing adherence to major obstetric societies' pre-eclampsia prevention recommendations. This pattern is consistent with new research from India showing that low-dose aspirin is safe and effective in lowering pregnancy-related hypertensive disorders. To avoid misuse, however, extensive empirical use necessitates close clinical supervision, especially with regard to dosage, timing, and contraindications.

One promising strategy to improve medication monitoring and counseling is the integration of AI and mHealth platforms. Digital systems can offer real-time guidance, reminders, and symptom tracking in multiple regional languages, as shown by applications like GynoSakhi, mMitra, and SwasthGarbh (IIT Roorkee & AIIMS Delhi). AI-based decision-support tools for community health workers (ASHA, ANM) can improve adherence to national treatment guidelines, decrease medication errors, and identify high-risk pregnancies. However, there are still gaps in equitable digital access, clinician acceptance, and validation, especially for rural populations.

Pharmacotherapy can be optimized and knowledge gaps filled by using real-world data registries, predictive analytics, and the ethical inclusion of pregnant women in controlled clinical trials. To guarantee that technological tools enhance clinical judgment rather than replace it, obstetricians, pharmacologists, bioethicists, and AI developers must work together.

Future Perspectives: Ayurvedic Medicine's Function in Pregnancy

With its natural formulations that emphasize hormonal balance, fetal protection, and maternal nourishment, Ayurveda presents exciting opportunities for future integrative prenatal care [9]. Common Ayurvedic medications like ashwagandha (Withania somnifera) and shatavari (Asparagus racemosus) are being researched for their stress-relieving, galactagogue, and adaptogenic qualities. Triphala and Amalaki offer digestive and antioxidant support, while Phalaghrita and Garbhapal Ras are traditionally used to fortify the uterus and prevent miscarriage.

Emerging studies indicate these formulations may improve maternal outcomes, but standardization, dose validation, and safety testing are essential before clinical use. Future research should integrate Ayurvedic approaches with modern pharmacotherapy through AI-based monitoring and pharmacovigilance systems to ensure safety and evidence-based adoption [9].

Ayurveda, supported by digital innovation and scientific validation, may thus contribute to safer, holistic, and culturally rooted pregnancy care in India’s maternal health framework.

DISCUSSION

Interpretation of Findings

According to our community-based survey, pregnant women use low-dose aspirin (90%) and supplements (92%) at remarkably high rates. This shows that current obstetric guidelines for maternal nutritional support and pre-eclampsia prevention are being closely followed. The low usage of analgesics (8.5%) and Ayurvedic preparations (2.5%), respectively, indicates that the population under study prefers evidence-based pharmacotherapy. The results also imply that there is a growing understanding of medication safety, which may be due to digital counseling and AI-assisted interventions.

Comparison with Previous Studies

The strong adherence to low-dose aspirin that has been found is in line with research from low- and middle-income nations that shows how safe and effective aspirin is at preventing pregnancy-related hypertension problems. Likewise, the adoption of mHealth initiatives like mMitra corresponds with documented enhancements in maternal awareness and care-seeking practices in Indian communities. Our findings highlight the importance of locally relevant guidelines and culturally appropriate treatments in improving medication adherence when compared to global statistics.

Clinical Implications

In order to reduce fetal risk, these results highlight the significance of trimester-specific dosing, close observation, and patient counseling. In India, the growing use of AI and mHealth tools like GynoSakhi, SwasthGarbh, and mMitra can support clinical decision-making by offering risk stratification, symptom tracking, and real-time reminders, particularly in setting with limited resources. Medication errors may be decreased and maternal and newborn outcomes may be enhanced by integrating these tools with national treatment guidelines.

Limitations

Even though the survey offers insightful information, there are a few limitations that should be noted:
Since the study only looked at one community (Ch. Sambhajinagar), it might not be entirely representative of India.

Self-reported information was used in part to collect the data, which could have introduced bias in reporting or recall.

With no quantitative indicators of effectiveness or adherence, the evaluation of AI/mHealth tools was descriptive in nature.

FUTURE DIRECTIONS

Completing multi-center research to document regional differences in drug use. Utilizing controlled trials to assess the clinical impact and efficacy of AI/mHealth platforms. Investigating integrative methods, which integrate contemporary pharmacotherapy with Ayurvedic medicine and are tracked by AI-based pharmacovigilance systems. studies that evaluate the effects of in utero exposure to drugs and supplements on the health of the mother over the long term and the outcomes of the fetus.

CONCLUSION:

A precise, evidence-based strategy that takes into account both the safety of the fetus and the benefit to the mother is required when using medications during pregnancy. Drug disposition is greatly altered by physiological changes, requiring careful monitoring and customized dosage. Despite the demonstrated advantages of essential supplements and low-dose aspirin, the risk of teratogenicity emphasizes the need for careful prescription and patient counseling.

Prenatal care in India is being redefined by AI-driven and mHealth innovations that improve medication safety, awareness, and accessibility, particularly in underprivileged areas. These tools must support fair access, adhere to national guidelines, and go through a rigorous validation process in order to reach their full potential. To promote precision medicine in maternal healthcare, future studies should give special attention to pharmacogenomic insights, ethical clinical trials, and longitudinal follow-up.

ACKNOWLEDGMENTS

The authors sincerely thanks Yash Institute of Pharmacy and Dr. Nilima N. Khakal for their guidance and support in the completion of this work.

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