Assessment of Youtube Videos As a Source of Information on Medication Use in Pregnancy

Theoretical Background and research questions/hypothesis:  Theoretical Background and research questions/hypothesis: Many women consult the Internet and social media when making decisions about medication use in pregnancy. However, across websites, information about medication safety is inconsistent and often inaccurate; sources often lack sufficient data to support their claims. Our objective was to assess content on medication use in pregnancy available through a single social media outlet, YouTube.

Methods: Using 2,023 distinct combinations of search terms related to medications and pregnancy, we extracted information (e.g., video title, publication date, views) from the YouTube Application Programming Interface (API) metadata in June 2014. After excluding videos that did not have at least one medication and one pregnancy-related term in the title, we manually reviewed relevant videos and recorded additional content (e.g., video source, type of medication, health outcomes mentioned) from each video for analyses. For medication products abstracted, we compared the safety of the medication in pregnancy suggested by the YouTube videos with the risk rating listed in the Teratogen Information System (TERIS), a subscription database that summarizes risks of medication exposures in pregnancy and assesses the quantity and quality of data available to make the risk determination.

Results: The YouTube API feed provided data on 41,438 distinct videos. Of these, 651 had at least one medication and one pregnancy-related search term in the video title. After manual review, 314 had relevant information about medication use in pregnancy and were included in the analyses. The majority of videos were of “legal” origin (210/314; 67%). The videos with the largest mean views since uploading (331.5 mean views per 30 days) were from physician/nurse sources. Seventy-four percent of the videos mentioned birth defect outcomes caused by prenatal medication use, with heart defects as the most common outcome mentioned. Selective serotonin reuptake inhibitors (SSRIs) were the most common medication class mentioned (225/314; 72% of videos). Eighty-eight percent of these videos deemed SSRIs to be unsafe; in contrast, the TERIS risk ratings for SSRIs range from “unlikely” to pose a risk for birth defects to “minimal” risk.

Conclusions: To our knowledge, this is the first assessment of the content of YouTube videos about medication use in pregnancy. People seeking information about the safety of medications in pregnancy from YouTube videos should be mindful of the information source when drawing conclusions about the risk of specific medication products. For selected medications, such as SSRIs, the current YouTube video content does not adequately reflect what is known about the safety of their use in pregnancy and disproportionately highlights risks associated with certain classes of medications.

Implications for research and/or practice: Given the high utilization of the Internet for health information, YouTube could serve as a valuable platform for communicating evidence-based medication safety information.