Trends and Determinants of Prescription Drug Use during Pregnancy and Postpartum in British Columbia, 2002–2011: A Population-Based Cohort Study

Abstract

PurposeTo describe trends, patterns, and determinants of prescription drug use during pregnancy and postpartum.MethodsThis is a retrospective, population-based study of all women who gave birth between January 2002 and 31 December 2011 in British Columbia, Canada. Study population consisted of 225,973 women who had 322,219 pregnancies. We examined administrative datasets containing person-specific information on filled prescriptions, hospitalizations, and medical services. Main outcome measures were filled prescriptions during pregnancy and postpartum. We used logistic regressions to examine associations between prescription drug use and maternal characteristics.ResultsApproximately two thirds of women filled a prescription during pregnancy, increasing from 60% in 2002 to 66% in 2011. The proportion of pregnant women using medicines in all three trimesters of pregnancy increased from 20% in 2002 to 27% in 2011. Use of four or more different types of prescription drug during at least one trimester increased from 8.4% in 2002 to 11.7% in 2011. Higher BMI, smoking during pregnancy, age under 25, carrying multiples, and being diagnosed with a chronic condition all significantly increased the odds of prescription drug use during pregnancy.ConclusionsThe observed increase in the number of prescriptions and number of different drugs being dispensed suggests a trend in prescribing practices with potentially important implications for mothers, their neonates, and caregivers. Monitoring of prescribing practices and further research into the safety of most commonly prescribed medications is crucial in better understanding risks and benefits to the fetus and the mother.

Postpartum Hemorrhage and Use of Serotonin Reuptake Inhibitor Antidepressants in Pregnancy

“…15 Although research suggests considerable variation both temporally and geographically, two recent Canadian and American studies reported that approximately 5% of women used antidepressants at some point during their pregnancy. 16,17 The most commonly used antidepressants are serotonin reuptake inhibitors, including selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors. 17,18 The use of serotonin reuptake inhibitors has been associated with an increased risk of bleeding events among nonpregnant participants.…”

Utilização de medicamentos antes e durante a gestação: prevalência e fatores associados

“…Diversos estudos mostram que o consumo de medicamentos está associado a ter problemas de saúde, inclusive durante a gestação 18,45,46 . Mesmo em países desenvolvidos, como o Canadá, por exemplo, um estudo de base populacional encontrou que ter uma doença crônica (OR = 2,01; IC95%: 1,98-2,05) deixou as gestantes mais susceptíveis a receberem prescrições de medicamentos durante a gravidez 46 .…”

“…Diversos estudos mostram que o consumo de medicamentos está associado a ter problemas de saúde, inclusive durante a gestação 18,45,46 . Mesmo em países desenvolvidos, como o Canadá, por exemplo, um estudo de base populacional encontrou que ter uma doença crônica (OR = 2,01; IC95%: 1,98-2,05) deixou as gestantes mais susceptíveis a receberem prescrições de medicamentos durante a gravidez 46 . Esses fatores aumentaram o contato entre o prescritor e a gestante, e isso foi associado a um maior consumo de medicamentos, que pode ter ocorrido por real necessidade de tratamento para uma patologia ou por causa de queixas comuns da gravidez, sendo elas muitas vezes condições autolimitadas que poderiam ser resolvidas sem intervenções farmacoterapêuticas.…”

Prescription drug use in pregnancy and variations according to prior psychiatric history

“…Despite general concern, the prescription drug use during pregnancy has increased in the past decades, and studies from the Nordic countries showed that about 46% to 57% of the women used a prescription drug during pregnancy . In Denmark, an increase from 44.2% in 1991‐1996 to 56.0% in 1999‐2009 was reported, although studies outside the Nordic countries showed an even higher proportion of women taking drugs during pregnancy (82.5% in the United States) . Across studies, the most commonly prescribed drug class was systemic anti‐infectives, but differences have been observed, eg, as the use had increased in Denmark, but not in Canada .…”