Drug-related adverse events or adverse drug reactions (ADRs) are currently partially or substantially under-reported. ADR reporting systems need to expand their focus to include sex- and gender-related factors in order to understand, prevent, or reduce the occurrence of ADRs in all people, particularly women. This scoping review describes adverse drug reactions reported to international pharmacovigilance databases. It identifies the drug classes most commonly associated with ADRs and synthesizes the evidence on ADRs utilizing a sex- and gender-based analysis plus (SGBA+) to assess the differential outcomes reported in the individual studies. We developed a systematic search strategy and applied it to six electronic databases, ultimately including 35 papers. Overall, the evidence shows that women are involved in more ADR reports than men across different countries, although in some cases, men experience more serious ADRs. Most studies were conducted in higher-income countries; the terms adverse drug reactions and adverse drug events are used interchangeably, and there is a lack of standardization between systems. Additional research is needed to identify the relationships between sex- and gender-related factors in the occurrence and reporting of ADRs to adequately detect and prevent ADRs, as well as to tailor and prepare effective reporting for the lifecycle management of drugs.

The regulation of prescription drugs is an important health, safety, and equity issue. However, regulatory processes do not always consider evidence on sex, gender, and factors such as age and race, omissions that advocates have highlighted for several decades. Assessing the impact of sex-related factors is critical to ensuring drug safety and efficacy for females and males, and for informing clinical product monographs and consumer information. Gender-related factors affect prescribing, access to drugs, needs and desires for specific prescribed therapies. This article draws on a policy-research partnership project that examined the lifecycle management of prescription drugs in Canada using a sex and gender-based analysis plus (SGBA+) lens. In the same time period, Health Canada created a Scientific Advisory Committee on Health Products for Women, in part to examine drug regulation. We report on grey literature and selected regulatory documents to illustrate the extent to which sex and gender-based analysis plus (SGBA+) is utilized in regulation and policy. We identify omissions in the management of prescription drugs, and name opportunities for improvements by integrating SGBA+ into drug sponsor applications, clinical trials development, and pharmacovigilance. We report on recent efforts to incorporate sex disaggregated data and recommend ways that the management of prescription drugs can benefit from more integration of sex, gender, and equity.

Both sex-related factors and gender-related factors affect the immediate and long term mental and physical health impacts of disasters, including those resulting from public health emergencies, climate-related events, and naturally occurring phenomena. These include sex-specific biological, physiological and genetic processes, mechanisms underlying reproduction, disease outcomes, and stress, immune, and trauma responses. Gendered factors such as roles, relations, identity, and institutional policies that have an impact on caregiving, occupation, gender-based violence, and access to healthcare, also influence the impacts of disasters and emergencies. Sex/gender factors interact with a range of social determinants to affect the equitability of impacts. A rapid review was conducted to examine evidence from Australia, Canada, countries from the European Union, New Zealand, the United Kingdom (UK), and the United States of America (USA) on the influence of sex- and gender-related factors in the context of disasters, such as COVID-19, earthquakes, floods, hurricanes, and wildfires. This article describes and categorizes this evidence with attention to real-world impacts of the interactions between sex, gender, and other equity related factors. Broad considerations for improving research and practices to support more sex and gender research in this area and ultimately, to improve emergency and disaster management, are discussed.

Background/Objectives: There is limited research on vaping during pregnancy and the postpartum period. Amid the legalization of cannabis in Canada, and evolving patterns of nicotine use, there is a growing need to understand how women experience using nicotine and cannabis vaping during pregnancy and postpartum. This information is essential to inform both women and healthcare providers (HCPs) and to develop resources and best practices for supporting women and healthcare services. Methods: In this descriptive study, a sample of 111 women who vaped nicotine and/or cannabis during pregnancy/postpartum was recruited via social media to answer survey questions on reasons for vaping, perceptions of the risks to fetal and maternal health, attitudes toward vaping, and reasons for consulting HCPs regarding vaping during pregnancy. Results: Among the 111 women, 51.4% vaped nicotine, 27.9% vaped cannabis, and 20.7% vaped both. Of the respondents, 63.1% were currently pregnant, while 36.9% were postpartum. Most participants (64.9%) reported vaping daily, followed by 15.3% with an inconsistent pattern, 9.9% vaping 1–2 days a week, and 9% vaping 5–6 days a week. Flavor preferences were prevalent, with fruit flavors being the most popular, followed by menthol/mint and candy, dessert, or sweet flavors. The primary reasons for vaping were relaxation, managing anxiety/depression, enjoyment, and the belief that vaping is less harmful than smoking. Women commonly consulted HCPs about potential harm to their pregnancy, fetal health, and their child’s health. Conclusions: The findings suggest that vaping among pregnant and postpartum women, particularly cannabis vaping, is perceived as healthier than smoking and is often used to manage mental and physical symptoms. These findings were used to create knowledge products to help guide HCPs’ conversations with women and provide evidence-based information on vaping.

There are a range of factors that influence alcohol use in pregnancy and create risk of fetal harm. However, limited research has articulated the multilevel nature of these influences and their entanglement. The purpose of this narrative review is to analyze the types of factors that influence alcohol use and consider what factors need to be addressed in future health promotion and intervention efforts. Six databases were searched using EBSCOhost articles published between January and December 2023 on alcohol use in pregnancy and Fetal Alcohol Spectrum Disorder (FASD) prevention. English-language articles were screened for relevance and a subset of articles exploring the prevalence, influences, and risk-factors associated with pregnancy were included for analysis. Thirty-two (n = 32) articles were included in the review and categorized into five key areas of influence on maternal alcohol use: (1) informational factors; (2) stress-related factors; (3) social determinant of health-related (SDoH) influences; (4) preconception- and prenatal-health-related factors; and (5) structural factors. Future efforts to reduce alcohol use in pregnancy should address these five categories of factors through non-judgmental, health-promoting, trauma-informed, harm-reduction-oriented, and culturally safe education, programming, and policy.