Comparison of electronic self‐reported prescription medication use during pregnancy with the national prescription register in Denmark

Laursen, Maja; Hallgreen, Christine Erikstrup; Dreyer, Nancy A; Bourke, Alison; Mt‐Isa, Shahrul; Blackburn, Stella

doi:10.1002/pds.4937

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…Another limitation is the potential misclassification of the exposures, as non-adherence to prescribed antibiotics in pregnancy has been reported. 42 A Danish study found a sensitivity of 93% and a specificity of 88% for antibiotic-prescription fills when compared with self-report in prospective biweekly questionnaires. 42 It is unknown whether such non-adherence differs by antibiotic substance.…”

Section: Discussionmentioning

confidence: 99%

Prenatal exposure to nitrofurantoin and risk of childhood leukaemia: a registry-based cohort study in four Nordic countries

Hjorth

Pottegård

Broe

et al. 2021

International Journal of Epidemiology

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Background Studies have suggested increased risks of childhood leukaemia after prenatal exposure to antibiotics, particularly nitrofurantoin. However, these findings may be related to the underlying maternal infection. This multinational study aimed to investigate the association between prenatal nitrofurantoin exposure and childhood leukaemia while accounting for maternal infection. Methods In a population-based cohort study of children born in Denmark, Finland, Norway or Sweden from 1997 to 2013, prenatal exposure to nitrofurantoin or pivmecillinam (active comparator) was ascertained from national Prescription Registries. Childhood leukaemia was identified by linkage to national Cancer Registries. Poisson regression was used to estimate incidence rate ratios (IRRs) and incidence rate differences (IRDs) with inverse probability of treatment weights applied to account for confounding. Results We included 44 091 children prenatally exposed to nitrofurantoin and 247 306 children prenatally exposed to pivmecillinam. The children were followed for 9.3 years on average (standard deviation 4.1). There were 161 cases of childhood leukaemia. The weighted IRR for prenatal nitrofurantoin exposure when compared with pivmecillinam was 1.34 (95% confidence interval 0.88, 2.06), corresponding to an IRD of 15 per million person-years. Higher point estimates were seen for first- and third-trimester exposure. There was no evidence of a dose–response relationship. Conclusions Prenatal exposure to nitrofurantoin was not substantially associated with childhood leukaemia, although a slightly elevated IRR with confidence intervals including the null was observed, corresponding to a small absolute risk. The lack of a dose–response relationship and a clear biological mechanism to explain the findings suggests against a causal association.

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Section: Discussionmentioning

confidence: 99%

Prenatal exposure to nitrofurantoin and risk of childhood leukaemia: a registry-based cohort study in four Nordic countries

Hjorth

Pottegård

Broe

et al. 2021

International Journal of Epidemiology

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“…This could reflect low awareness of medications taken during labor and delivery, lack of familiarity with types of medications during pregnancy, or low adherence to prescriptions. Prior literature has also shown that while concordance between self‐report and health record data is strong for medications used chronically, there tends to be much lower concordance for shorter‐term medication use, including antibiotic use during pregnancy [Cheung et al, 2017; Laursen et al, 2019; Palmsten et al, 2018; Pisa et al, 2015; Sarangarm et al, 2012]. Lastly, we relied on self‐report information on infections.…”

Section: Discussionmentioning

confidence: 99%

Interaction between Maternal Immune Activation and Antibiotic Use during Pregnancy and Child Risk of Autism Spectrum Disorder

et al. 2020

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Prenatal exposure to maternal immune activation (MIA) has been implicated as a risk factor for the development of autism spectrum disorder (ASD), though the conditions under which this elevated risk occurs are unclear. Animal literature demonstrates that antibiotic use, which affects the composition of the maternal gut microbiota, modifies the effect of MIA on neurodevelopmental outcomes in the offspring. The aim of this study was to assess whether antibiotic use during pregnancy modifies the association between MIA and subsequent risk of ASD, in a prospective birth cohort with 116 ASD cases and 860 typically developing (TD) child controls. There was no evidence of interaction between fever or genitourinary infection and antibiotic use on the odds of ASD in unadjusted or adjusted analyzes. However, we found evidence of an interaction between flu, specifically in second trimester, and antibiotic use at any point during pregnancy on the odds of ASD in the child. Among women who received an antibiotic during pregnancy, flu in trimester two was not associated with ASD (adjusted odds ratio [aOR] = 0.99 [0.43-2.28]). Among women who were not exposed to an antibiotic at any point during pregnancy, flu in second trimester was significantly associated with increased odds of ASD (aOR = 4.05 [1.14-14.38], P = .03), after adjustment for child sex, child birth year, maternal age, gestational age, C-section delivery, and low birthweight. These findings should be treated as hypothesis-generating and suggest that antibiotic use may modify the influence that MIA has on autism risk in the child.

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“…We did not use data from NorPD on filled prescriptions for NSAIDs, as (a) some NSAIDs (ibuprofen, diclofenac, and naproxen) are available over‐the‐counter, and (b) the filled prescriptions may be used in a later trimester than it was filled, or not at all. The first point is supported by a Danish study comparing self‐reported use of acetaminophen or NSAIDs (investigated as one group) to prescription fills 32 . In 95% of 348 self‐reports of use, the medication was purchased over‐the‐counter 32 .…”

Section: Methodsmentioning

confidence: 99%

“…The first point is supported by a Danish study comparing self‐reported use of acetaminophen or NSAIDs (investigated as one group) to prescription fills 32 . In 95% of 348 self‐reports of use, the medication was purchased over‐the‐counter 32 . The number of identified prescription fills was correspondingly low (20 fills in total) 32 …”

Section: Methodsmentioning

confidence: 99%

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Prenatal exposure to non‐steroidal anti‐inflammatory drugs and risk of attention‐deficit/hyperactivity disorder: A follow‐up study in the Norwegian mother, father and child cohort

Hjorth

Lupattelli

Handal

et al. 2021

Pharmacoepidemiology and Drug

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Purpose To estimate the association between Attention‐Deficit/Hyperactivity Disorder (ADHD) in children in preschool and primary school, and prenatal exposure to non‐steroidal anti‐inflammatory drugs (NSAIDs) by timing and duration. Methods This study was based on the Norwegian Mother, Father and Child Cohort Study linked to the Medical Birth Registry of Norway, the Norwegian Patient Registry (NPR) and the Norwegian Prescription Database (NorPD). NSAID exposure was identified by maternal self‐report in pregnancy. Child diagnosis of ADHD was obtained from NPR and NorPD. Symptoms of ADHD at age 5 years were measured using Conners' Parent Rating Scale‐Revised, where higher scores correspond to more symptoms. To account for time‐varying exposure and confounders, marginal structural models were fitted to estimate hazard ratios and mean difference in z‐scores. Results The analyses on ADHD diagnosis and ADHD symptoms included 56 340 and 34 961 children respectively. Children exposed to NSAIDs prenatally had no increased risk of ADHD diagnosis (first trimester: HR 1.12, 95% CI 0.86;1.45, second trimester: HR 0.98, 95% CI 0.69;1.38, third trimester: HR 0.68, 95% CI 0.31; 1.46) or ADHD symptoms (first trimester: standardized mean difference 0.03, 95% CI −0.03;0.09, second trimester: standardized mean difference 0.03, 95% CI −0.04;0.11, third trimester: standardized mean difference 0.11, 95% CI −0.03; 0.25). There was no duration‐response relationship for either outcome. Conclusion Though non‐differential misclassification of the exposure may have attenuated results, these findings are reassuring and suggest no substantially increased risk of ADHD diagnosis or symptoms in children prenatally exposed to NSAIDs, regardless of timing or duration.

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Comparison of electronic self‐reported prescription medication use during pregnancy with the national prescription register in Denmark

Cited by 8 publications

References 17 publications

Prenatal exposure to nitrofurantoin and risk of childhood leukaemia: a registry-based cohort study in four Nordic countries

Prenatal exposure to nitrofurantoin and risk of childhood leukaemia: a registry-based cohort study in four Nordic countries

Interaction between Maternal Immune Activation and Antibiotic Use during Pregnancy and Child Risk of Autism Spectrum Disorder

Prenatal exposure to non‐steroidal anti‐inflammatory drugs and risk of attention‐deficit/hyperactivity disorder: A follow‐up study in the Norwegian mother, father and child cohort

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