Agreement between administrative databases and medical charts for pregnancy‐related variables among asthmatic women

Vilain, Anne; Otis, Sophie; Forget, Amélie; Blais, Lucie

doi:10.1002/pds.1558

Cited by 85 publications

(111 citation statements)

References 34 publications

(28 reference statements)

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“…9,27,28 Einarson and colleagues found no statistically significant association between venlafaxine use during pregnancy and the risk of spontaneous abortion among 150 women. 18 Two recent reviews reported contradictory findings.…”

Section: Discussionmentioning

confidence: 99%

“…8,11 Nevertheless, our findings are similar to those of Einarson and colleagues, who showed that overall antidepressant use during early gestation increased the risk of spontaneous abortion by 63%. 18 Much remains unclear with regard to the exact mechanism of action, although it has been suggested that the effect of selective serotonin reuptake inhibitors on spontaneous abortion is probably mediated by a serotonergic mechanism.…”

Section: 12mentioning

confidence: 99%

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Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Bérard³

2010

Canadian Medical Association Journal

136

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; Centre hospitalier universitaire Sainte-Justine (Nakhai-Pour, Broy, Bérard), University of Montreal, Montréal, Que.; École nationale de la statistique et de l'analyse de l'information (Broy), Rennes, France; and the Ministry of Health and Medical Education (Nakhai-Pour), Tehran, Iran CMAJ 2010. DOI:10.1503/cmaj.091208 Background:The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. Methods:Using a nested case-control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case's index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants.Results: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an anti depressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83-2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38-2.06). Stratified analyses showed that use of selective serotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28-2.04), serotonin-norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34-3.30) and combined use of antidepressants from different classes (OR 3.51, were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31-2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34-3.30) were associated with an increased risk of spontaneous abortion. Interpretation:The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion. Abstract

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Section: Discussionmentioning

confidence: 99%

Section: 12mentioning

confidence: 99%

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Bérard³

2010

Canadian Medical Association Journal

136

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“…Data recorded in these three databases have been validated previously. [8][9][10] Studies involving pregnant women insured by the RAMQ for their medications have been shown to generate valid risk estimates. 7 Our study was approved by the Centre hospitalier universitaire Ste -Justine Ethics Committee, and the linkage between databases was approved by the Commission d'accès à l'information du Québec.…”

Section: Methodsmentioning

confidence: 99%

“…We also used physician-based diagnoses and records of procedures related to spontaneous abortion, which limited the potential for detection and misclassification biases on outcome status. Gestational age, validated by Vilain and coworkers, 9 was obtained from hospital charts on the index date, allowing us to calculate the exact timing of exposure to nonaspirin NSAIDs during pregnancy. We adjusted our results for indication for the use of nonaspirin NSAIDs by adjusting for variables such as history of rheumatoid arthritis and systemic lupus, and for the duration of exposure in the year before pregnancy; we further adjusted for history of planned and spontaneous abortions.…”

mentioning

confidence: 99%

Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Sheehy³

et al. 2011

CMAJ

136

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N onaspirin nonsteroidal antiinflammatory drugs (NSAIDs) are one of the most commonly used medications during pregnancy (17%).1 Nevertheless, gestational use of nonaspirin NSAIDs remains controversial, partly due to the inconsistency of results from studies on their potential risks, the potential for residual confounding by comorbidities and the lack of data on the risks associated with specific types and dosages. [1][2][3][4][5] The strongest association thus far was seen when nonaspirin NSAIDs had been used close to the time of conception, suggesting bias that could be partly explained by women using the drug to alleviate cramping, a precursor to spontaneous abortion. 4 No one has documented the risk of spontaneous abortion according to type and dosage of nonaspirin NSAIDs -both important elements to consider when determining causality.We performed a nested case-control study to quantify the risk of spontaneous abortion associated with specific types and dosages of nonaspirin NSAIDs in a cohort of pregnant women, adjusting for potential confounders. Methods Study designWe used a nested case-control study design. We chose this design because it shows similar effect sizes to a prospective cohort approach with timevarying exposure to medication, but with greater computational efficiency. Data collectionWe used data from the Quebec Pregnancy Registry, an ongoing registry of all pregnancies in Quebec since 1997. Records in the registry are Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortionHamid Reza Nakhai-Pour MD PhD, Perrine Broy BSc, Odile Sheehy MSc, Anick Bérard PhD The association between the use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy and the risk of spontaneous abortion remains unclear because of inconsistent research results and the lack of evidence for an effect due to specific types or dosages of nonaspirin NSAIDs. We aimed to quantify the association between having a spontaneous abortion and types and dosages of nonaspirin NSAIDs in a cohort of pregnant women.

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“…We determined the day of the last menstrual period (defined as the first day of gestation) using data on gestational age, which was validated against data in patient charts and ultrasound measures. 10 Prospective follow-up data were available from 1 year before the first day of gestation, during pregnancy and until December 2009. The data sources for this study included RAMQ (diagnoses, medical procedures, socioeconomic status of women and prescribers), the province's Public Prescription Drug Insurance Plan database (drug name, start date, dosage and duration), MED-ÉCHO (in-hospital diagnoses and procedures, and gestational age) and the Institut de la statistique du Quebec (patient sociodemographic data and birth weight).…”

Section: Data Sourcesmentioning

confidence: 99%

Use of antibiotics during pregnancy and risk of spontaneous abortion

Muanda

Sheehy

Bérard

2017

CMAJ

113

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BACKGROUND: Although antibiotics are widely used during pregnancy, evidence regarding their fetal safety remains limited. Our aim was to quantify the association between antibiotic exposure during pregnancy and risk of spontaneous abortion. METHODS:We conducted a nested case-control study within the Quebec Pregnancy Cohort (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009). We excluded planned abortions and pregnancies exposed to fetotoxic drugs. Spontaneous abortion was defined as having a diagnosis or procedure related to spontaneous abortion before the 20th week of pregnancy. The index date was defined as the calendar date of the spontaneous abortion. Ten controls per case were randomly selected and matched by gestational age and year of pregnancy. Use of antibiotics was defined by filled prescriptions between the first day of gestation and the index date and was compared with (a) non-exposure and (b) exposure to penicillins or cephalosporins. We studied type of antibiotics separately using the same comparator groups. RESULTS:After adjustment for potential confounders, use of azithromycin (adjusted odds ratio [OR] 1.65, 95% confidence interval [CI] 1.34-2.02; 110 exposed cases), clarithromycin (adjusted OR 2.35, 95% CI 1.90-2.91; 111 exposed cases), metronidazole (adjusted OR 1.70, 95% CI 1.27-2.26; 53 exposed cases), sulfonamides (adjusted OR 2.01, 95% CI 1.36-2.97; 30 exposed cases), tetracyclines (adjusted OR 2.59, 95% CI 1.97-3.41; 67 exposed cases) and quinolones (adjusted OR 2.72, 95% CI 2.27-3.27; 160 exposed cases) was associated with an increased risk of spontaneous abortion. Similar results were found when we used penicillins or cephalosporins as the comparator group. INTERPRETATION:After adjustment for potential confounders, use of macrolides (excluding erythromycin), quinolones, tetracyclines, sulfonamides and metronidazole during early pregnancy was associated with an increased risk of spontaneous abortion. Our findings may be of use to policy-makers to update guidelines for the treatment of infections during pregnancy.

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Agreement between administrative databases and medical charts for pregnancy‐related variables among asthmatic women

Abstract: Pregnancy-related variables recorded in administrative databases or derived from algorithms based on two or more databases were found to be highly valid as compared to the medical chart among asthmatic women.

Cited by 85 publications

References 34 publications

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion

Use of antibiotics during pregnancy and risk of spontaneous abortion

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