Drug use for gastrointestinal symptoms during pregnancy: A French nationwide study 2010–2018

Abstract

Purpose To describe drug prescription for gastrointestinal symptoms during pregnancy. Methods Using the French national health database, we identified pregnancies ending with a birth between April 2010 and December 2018, in France. We studied prescription of antacids, antispasmodics, antinauseants, laxatives and antidiarrheals during pregnancy, between two trimesters before and two trimesters after delivery. We also assessed hospitalization for gastrointestinal symptoms during pregnancy. Results Among 6,365,471 pregnancies, 4,452,779 (74.0%) received at least one gastrointestinal drug during pregnancy; 2,228,275 (37.0%) received an antacid, 3,096,858 (51.5%) an antispasmodic, 1,861,731 (31.0%) an antinauseant, 919,116 (15.3%) a laxative and 617,808 (10.3%) an antidiarrheal. Prescription of proton pump inhibitors doubled from 12.2% in 2010 to 26.0% in 2018, while domperidone use decreased from 18.3% in 2010 to 2.2% in 2018. In addition, prescription of antacids increased from 7.0% during the trimester before pregnancy to 11.8% during the 1st trimester, 17.0% during the 2nd trimester and 23.4% during the 3rd trimester. Antispasmodic use was 10.6% during the trimester before pregnancy, 23.1% during the 1st trimester, 25.2% during the 2nd trimester and 24.0% during the 3rd trimester. Prescription of antinauseant drugs increased from 5.0% during the trimester before pregnancy to 25.7% during the 1st trimester, then decreased to 6.4% during the 2nd trimester and 3.2% during the 3rd trimester. Nausea/vomiting was the most common cause of hospitalization for gastrointestinal symptoms or diseases during pregnancy, although it accounted for only 1.0% of pregnancies. Conclusions Approximately three-quarters of women use drugs for gastrointestinal symptoms during pregnancy in France. Prescription of gastrointestinal drugs during pregnancy should be the subject of more detailed risk-benefit assessment and recommendations.

What changes in prescription patterns of antiemetic medications in pregnant women in France?

“…Metoclopramide (16.7%), domperidone (10.3%), and metopimazine (8.4%) were the most prescribed antiemetics, mainly during the first trimester of pregnancy. A study conducted between 2010 and 2018 in the French health data system highlighted similar trends, with 13.4% of pregnant women exposed to metoclopramide during the first trimester of pregnancy, 8.5% to domperidone and 8.2% to metopimazine [17]. Another study conducted in the French Echantillon Généraliste des Bénéficiaires (EGB), between 2010 and 2013, showed that 13.8% of pregnant women received metoclopramide during pregnancy and 13% received domperidone [18].…”

Registered Clinical Trials Comprising Pregnant Women in China: A Cross-Sectional Study

“…Although women during pregnancy demonstrate concerns with regard to drug safety, numerous women still use prescription drugs throughout pregnancy due to disease or abnormal reactions that may occur in pregnancy (e.g., hypertensive disorders of pregnancy or gestational diabetes) ( Anoshchenko et al, 2020 ). Approximately 40–80% of women receive at least one medication during pregnancy ( Meyer et al, 2021 ). However, the vast majority of newly marketed medications have not been evaluated with respect to pregnant women ( Ye et al, 2019 ; Carnovale et al, 2021 ).…”

Clinical Drug Trial Participation: Perspectives of Pregnant Women and Their Spouses

“…During pregnancy, about 58% to 97% of women take at least one drug. 1 The safety and effectiveness of the drugs used by pregnant women should have been proven, and more than half of pregnant women and their spouses have perceived needs for information about the safety and use of medications during pregnancy. 2 However, the vast majority of newly marketed drugs have no reported human pregnancy experience.…”