The French Pregnancy Cohort: Medication use during pregnancy in the French population

Abstract

Purpose We described the medication use during pregnancy in the French population using the French Pregnancy Cohort (FPC). Methods The FPC was built with the sampling of all pregnant women included in the French Echantillon généraliste des bénéficiaires (EGB), which is a 1/97 th representative sample of the population covered by the French health insurance. The EGB includes anonymized information on the socio-demographic and medical characteristics of beneficiaries, and the health care services they have received such as diagnoses and procedure codes as well as data on filled reimbursed medication; EGB also includes data on hospital stays in all public and private French health facilities. Each filled prescription record contains information on drug brand and generic names, date of prescription and date of dispensing, quantity dispensed, mode of administration, duration of prescription, dosage, and prescribing physician specialty. FPC includes data on all pregnancies of women in the EGB (2010–2013). Date of entry in the FPC is the first day of pregnancy regardless of pregnancy outcome (spontaneous abortions or planned abortions (with or without medical reasons), deliveries), and data on women are collected retrospectively for a period of one year before pregnancy, and prospectively during pregnancy, and up to one year after delivery. The prevalence of prescribed medications before, during and after pregnancy was compared; comparison was also done between trimesters. Pregnancy outcomes are described and include spontaneous and planned abortions, livebirths, and stillbirths. Results FPC includes data on 36,065 pregnancies. Among them, 27,253 (75.6%) resulted in a delivery including 201 stillbirths (0.7%). The total number of spontaneous abortions was 6,718 (18.6%), and planned abortions 2,094 (5.8%). The prevalence of filled medication use was 91.1%, 89.9%, and 95.6% before, during and after pregnancy, respectively. Although there was a statistically significant decrease in the proportion of use once the pregnancy was diagnosed (first trimester exposure, 76.4% vs. exposure in the year prior to pregnancy, 91.1% (p < .01)), post-pregnancy medication use was above the pre-pregnancy level (95.6%). Maternal depression was the most prevalent comorbidity during pregnancy (20%), and post-partum depression was higher in those who delivered a stillborn infant (38.8%) as well as in those with a spontaneous (19.5%) or planned abortion (22.4%) compared to those with a liveborn (12.0%). Conclusion FPC is an excellent tool for the study of the risk and benefit of drug use during the perinatal period. FPC has the advantage of including a representative sample of French pregnant women, and study medications only available in France in addition to others available worldwide.

Use, Awareness, Knowledge and Beliefs of Medication During Pregnancy in Malaysia

“…In Malaysia, the use of medication by women during pregnancy was prevalent in this current study, despite the substantial risks associated with the use of both over the counter and prescription drugs during pregnancy due to the lack of safety information of using medications during pregnancy [ 18 , 19 ]. The high prevalence of use of medication in this study (81.4%) was comparable to the outcome of other similar studies performed in France (89.9%) [ 20 ], Ethiopia (55.2%) [ 5 ], Australia (96–97%) [ 21 ], and Oman (48–49%) [ 22 ].…”

Prevention of Neural Tube Defects by Folic Acid Supplementation: A National Population-Based Study

“…We exhaustively collected data on the dispensing of folic acid in its dosage form reimbursed by public health insurance, whether for a first prescription or a renewal. Although the EGB represents only 1/97 of the French population covered by public health insurance, this sample is constituted randomly and such that the age and sex distributions are very close to those of the French population [ 18 ], which limits bias in selection of regional patient cohorts. There is, therefore, no reason to suppose that the rate of dispensing in the general population of pregnant women differs from that in our sample.…”

“…The EGB comprises anonymous information on public health insurance beneficiaries and on the health services they have received as outpatients and during hospitalization, such as data on the dispensing of reimbursed medication following a medical prescription [ 17 ]. The EGB is a permanent sample representative of 1/97 of the French population covered by public health insurance, with random constitution of the sample depending on individual social security numbers by 5-year age bracket and sex [ 17 , 18 ].…”

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

“…The SNDS contains all outpatient information (demographics, drugs dispensed, and procedures) and all inpatient information (expensive drugs dispensed, procedures performed during hospital stays, and diagnoses) [ 12 ]. Studies based on this database have produced meaningful results in recent years [ 13 – 17 ].…”