Use of analgesics during pregnancy: patterns of use and knowledge of medication safety among women in Serbia.

Background: Analgesics are commonly used during pregnancy, and their safe use depends on the type of drug, timing of exposure, and appropriateness of use. This study assessed patterns of analgesic use before and during pregnancy and evaluated women's knowledge and perceptions regarding analgesic safety during pregnancy in Serbia. Methods: A cross-sectional study was conducted using an electronically distributed, self-administered questionnaire adapted from a previously published instrument. The survey included socio-demographic and reproductive characteristics, patterns of analgesic use, and a 19-item knowledge inventory. Knowledge scores were categorized as low (<10 points) or high (≥10 points). Descriptive statistics and logistic regression were used for analysis. Results: A total of 538 women participated. Overall, 51.7% reported analgesic use during pregnancy, and among these, 50.7% reported use during the first trimester. Paracetamol was the most commonly used analgesic during pregnancy (93.9%). Analgesic use without prior consultation was reported by 32.0% of women who used analgesics during pregnancy. Before pregnancy, 83.1% reported analgesic use. Although 69.3% reported having received information about adverse effects, important uncertainty remained regarding NSAID classification and safety. Overall, 65.1% of respondents had a low level of knowledge. Health-professional background was strongly associated with a high level of knowledge (adjusted OR 12.468, 95% CI 7.502-20.724; p < 0.001). Conclusion: Analgesic use during pregnancy was common, including use without prior consultation. Despite recognizing paracetamol as the preferred analgesic, many women had limited knowledge regarding analgesic safety, particularly NSAIDs, in pregnancy. These findings support the need for improved counselling and targeted education on medication safety during pregnancy.