Prenatal medication use in a prospective pregnancy cohort by pre-pregnancy obesity status

Vafai, Yassaman; Yeung, Edwina; Sundaram, Rajeshwari; Smarr, Melissa M.; Gerlanc, Nicole; Grobman, William A.; Skupski, Daniel; Chien, Edward K.; Hinkle, Stefanie; Newman, Roger B.; Ranzini, Angela C.; Sciscione, Anthony; Grewal, Jagteshwar; Zhang, Cuilin; Grantz, Katherine L.

doi:10.1080/14767058.2021.1893296

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…Timing of diagnosis with gestational hypertension and preeclampsia was unknown, and therefore, whether caffeinated beverage intake later in pregnancy is associated with blood pressure, hypertension or preeclampsia risk requires future study. Also, the self-reported exposure represents caffeine from beverages only; notably only 2 women took medications containing caffeine …”

Section: Discussionmentioning

confidence: 88%

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Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications

et al. 2021

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IMPORTANCEWomen are recommended to limit caffeine consumption to less than 200 mg per day based on risks to fetal health. Impacts of caffeine on maternal health remain unclear. OBJECTIVE To determine whether caffeinated-beverage intake and plasma caffeine and paraxanthine are associated with cardiometabolic complications in pregnancy (ie, gestational diabetes [GDM], preeclampsia, and gestational hypertension [GH]). DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from a longitudinal pregnancy cohort study from the National Institute of Child Health and Human Development (NICHD) FetalGrowth Studies-Singletons (2009-2013. This post hoc secondary analysis of 2802 pregnant women without major chronic conditions enrolled at 12 US clinical sites was completed in 2021. The final sample for caffeinated beverage analyses included 2583 women. After excluding women who did not consent to have their biospecimens stored for future research (n = 54), plasma caffeine analyses included 2529 women. Analyses of caffeine consumption and fasting cardiometabolic profiles included 319 women. EXPOSURES Daily total caffeine intake was estimated at 10 to 13 gestational weeks and 16 to 22 gestational weeks based on self-reported past week intake of caffeinated coffee, tea, soda, and energy drinks. Plasma caffeine and paraxanthine were measured in specimens collected at 10 to 13 weeks. MAIN OUTCOMES AND MEASURESClinical diagnoses of GDM, preeclampsia, GH, glucose concentrations from GDM screening, and blood pressure were extracted from medical records. RESULTSParticipants had a mean (SD) age of 28.1 (5.5) years and 422 participants (16.3%) were Asian/Pacific Islander women, 741 (28.9%) were Hispanic women, 717 (27.8%) were non-Hispanic Black women, and 703 (27.2%) were non-Hispanic White women. At 10 to 13 weeks, 1073 women (41.5%) reported consuming no caffeinated beverages, 1317 (51.0%) reported consuming 1 mg/d to 100 mg/d, 173 (6.7%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d. At 16 to 22 weeks, 599 women (23.6%) reported consuming no caffeinated beverages, 1734 (68.3%) reported consuming 1 mg/d to 100 mg/d, 186 (7.3%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d caffeinated beverages. Intake at 16 to 22 weeks was associated with lower GDM risk and lower glucose concentrations (1 mg/d to 100 mg/d vs none: relative risk, 0.53 [95% CI, 0.35 to 0.80]; β, -2.7 mg/dL [95% CI, -5.4 mg/dL to 0 mg/dL]) and lower C-reactive protein and C-peptide concentrations and favorable lipid profiles. Total plasma caffeine and paraxanthine at 10 to 13 weeks was inversely associated with glucose (quartile 4 vs quartile 1: β = -3.8 mg/dL [95% CI, -7.0 mg/dL to -0.5 mg/dL]; trend of P = .01). No associations were observed with preeclampsia or GH.

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Section: Discussionmentioning

confidence: 88%

“…Also, the self-reported exposure represents caffeine from beverages only; notably only 2 women took medications containing caffeine. 44 …”

Section: Discussionmentioning

confidence: 99%

Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications

et al. 2021

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“…We screened 2228 titles and abstracts. Of those, 46 papers were subjected to detailed evaluation in full-text screening,4 6 20–63 and 14 met inclusion criteria 4 6 20–31. The main reasons for exclusion were an inadequate method of reporting prevalence of polypharmacy or reporting on specific subpopulation of pregnant women.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of polypharmacy in pregnancy: a systematic review

et al. 2023

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ObjectivesThe use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes.DesignMEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included.Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed.ResultsFourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy.ConclusionThere is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms.Tweetable abstractOur systematic review shows significant burden of polypharmacy in pregnancy but outcomes for women and offspring are unknown.PROSPERO registration numberCRD42021223966.

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Global prevalence of antibiotic consumption during pregnancy: A systematic review and meta-analysis

Orwa,

Gudnadottir,

Boven

et al. 2024

Journal of Infection

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Prenatal medication use in a prospective pregnancy cohort by pre-pregnancy obesity status

Cited by 4 publications

References 25 publications

Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications

Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications

Prevalence of polypharmacy in pregnancy: a systematic review

Global prevalence of antibiotic consumption during pregnancy: A systematic review and meta-analysis

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