Drug use during pregnancy in Sweden – assessed by the Prescribed Drug Register and the Medical Birth Register

Abstract

Purpose:The purpose of this research is to study drug use during pregnancy in Sweden and agreement between use according to antenatal medical records and dispensed drugs from a pharmacy database.Patients and methods:From the Swedish Medical Birth Register (MBR), we established a population-based cohort of 102,995 women who gave birth in 2007. Using the unique personal registration number, information on dispensed drugs from the Prescribed Drug Register (PDR) was obtained prior to, during, and after the pregnancies and compared with MBR information on drug use from standardized antenatal medical records.Results:According to the PDR, 57.6% of the 102,995 women filled a prescription with at least one drug during pregnancy and 50.9% during the lactating period (until 3 months after delivery). The most dispensed drugs during pregnancy were B-lactam antibacterials and penicillins. Agreement between drugs recorded in antenatal medical records and dispensed drugs was highest for drugs used for chronic conditions. The agreement was particularly high for thyroid therapy (85.3%), anti-intestinal inflammatory drugs (80.3%), antiepileptics (69.2%), immunosuppressants (67.4%), and insulin (63.8%). Agreement for drugs used for occasional use was generally lower, ranging between 42.5% for antihistamines and 0.8% for gynecological anti-infectives.Conclusions:A large proportion of women filled a prescription during pregnancy or the lactating period. Agreement between drug use in medical antenatal records and register information from a national pharmacy database was high for drugs used for chronic conditions but low for occasional use. For occasionally used drugs, medical record and register-based data may provide incomplete exposure information because of nonreporting or noncompliance.

Assessment of Drug Use and Effect in Pregnant Women Attending Antenatal Care in Hospitals of Mekelle, Tigray, Ethiopia

“…With average number of drugs prescribed per pregnant women of 1.86±0.94. This finding was comparable with a study done in Ethiopia (55.2%) 13 and Sweden (57.6%) 16 .…”

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

“…A comparação com as prevalências encontradas em países da Europa e nos Estados Unidos (14,2% a 43%) é dificultada pela variação no tempo de observação antes da gestação (30 dias a 3 anos) 6,7,8,9,10,23 , pois, no presente estudo, não houve delimitação de um período recordatório específico no momento da coleta dos dados sobre o uso de medicamentos antes da gestação.…”

“…Conforme esses estudos, as prevalências de uso de medicamentos antes da gestação em países europeus variam de 29,9% a 43%, sendo os grupos terapêuticos mais utilizados os antibacterianos de uso sistêmico, hormônios sexuais e anti-inflamatórios não esteroides 6,7,8,9,10 . Investigação realizada em cidade do Sul do Brasil mostrou que 46,7% das mulheres estavam em uso de medicamentos no momento do diagnóstico da gravidez.…”

“…No entanto, dado que nas sociedades modernas o uso de medicamentos tornou-se prática costumeira e de dimensão crescente, a exposição de conceptos em períodos iniciais da gestação é um evento de possibilidade frequente, especialmente em gravidezes não planejadas 6 . Tais fatores ressaltam a importância da realização de estudos observacionais sobre o uso de medicamentos na gravidez, que têm se intensificado nas últimas décadas 6 .Conforme esses estudos, as prevalências de uso de medicamentos antes da gestação em países europeus variam de 29,9% a 43%, sendo os grupos terapêuticos mais utilizados os antibacterianos de uso sistêmico, hormônios sexuais e anti-inflamatórios não esteroides 6,7,8,9,10 . Investigação realizada em cidade do Sul do Brasil mostrou que 46,7% das mulheres estavam em uso de medicamentos no momento do diagnóstico da gravidez.…”

Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records

“…It is likely, however, that this study may have underestimated the prevalence of antipsychotic use in pregnant women in the Swedish population. 49 Another study also using Swedish registry data, but from 2005 to 2009 estimated atypical antipsychotic use during pregnancy to be approximately 0.1%. 50 We found that quetiapine, olanzapine and risperidone were the three most commonly prescribed atypical antipsychotics both before and after pregnancy.…”