Drug use in first pregnancy and lactation: a population-based survey among Danish women

Olesen, Charlotte; Steffensen, Flemming Hald; Gl, Nielsen; Berg, LD Jong-van den; Ht, Sørensen; Olsen, Jørn

doi:10.1007/s002280050608

Cited by 137 publications

(136 citation statements)

References 22 publications

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“…Foram amostrados 10,3% (424) dos partos, sendo 64,6% (274) na maternidade privada e 35,4% (150) na pública, com distribuição mensal média de 16,7% (14,(9)(10)(11)(12)(13)(14)(15)(16)(17)9). Na maternidade particular 97,1% dos partos foram pagos por seguros-saúde e 2,9% por recursos particulares.…”

Section: Resultsunclassified

“…O uso de medicamentos no parto, do momento da internação até a alta, permanece pouco investigado embora represente um momento de alto risco de consumo. [5][6][7][8][9]11 Por ser limitado no tempo, em suas possibilidades terapêuticas e por sua forte importância sócio-cultural, representa um evento privilegiado na discussão sobre a racionalidade no consumo de medicamentos, com possibilidade de intervenção pouco discutida.…”

Section: Introductionunclassified

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Consumo de medicamentos no período de internação para o parto

Perini¹,

Magalhães²,

Noronha³

2005

Rev. Saúde Pública

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Descritores Uso de medicamentos. Gravidez. Lactação. Puerpério. Hospitalização. Maternidades. Anestesia. Cesárea. Parto. ResumoObjetivo O consumo de medicamentos no parto tem sido pouco explorado na literatura. Limitado no tempo e nas possibilidades terapêuticas, representa um evento privilegiado para discussão sobre o seu uso correto. Assim, realizou-se análise do consumo de medicamentos no parto, estabelecendo base para comparações entre maternidades. Métodos Estudo transversal envolvendo duas maternidades, uma particular e outra pública, de Belo Horizonte, Minas Gerais. Para a análise da utilização de medicamentos no período de internação das parturientes, foram coletados dados sobre identificação, gravidez, parto e medicamentos prescritos nos prontuários da maternidade pública, e na particular, nos prontuários e faturas. Para a análise estatística utilizou-se odds ratio (OR) testadas pelo qui-quadrado, e em médias pelo t de Student. Resultados O tempo médio de hospitalização foi de 2,2 dias, menor na maternidade particular. Partos cesáreos representaram 52,7%, 31,3% na pública e 64,5% na particular. A anestesia peridural foi utilizada em 72,8% dos casos e a local em 22,4% (25,3 e 63,7% na pública e 98,2 e 0,4% na particular). Todas as mulheres receberam medicamentos, com mínimo de três e máximo de 19 produtos diferentes. No total, 83 medicamentos (97 princípios ativos) foram utilizados com freqüência total de 3.429. Foi observado consumo médio maior na maternidade particular de 8,5 medicamentos por mulher. Conclusões Observou-se diferença significativa no consumo de medicamentos nas duas maternidades, maior nos procedimentos do pré-parto/parto. Em ambas as maternidades, o consumo mostrou-se elevado em relação às poucas evidências internacionais. O excesso de partos cesáreos e os procedimentos anestésicos explicam as diferenças quantitativas observadas. AbstractObjective Drug use in birth delivery has not been enough explored in the literature. It is a significant issue to be discussed on the theme of rational drug use. The objective was to study drug use during birth delivery stay in maternity hospitals.

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Section: Resultsunclassified

Section: Introductionunclassified

Consumo de medicamentos no período de internação para o parto

Perini¹,

Magalhães²,

Noronha³

2005

Rev. Saúde Pública

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“…In the 2 years before pregnancy, the prescription rate was constant, approximately 43 per 100 women. The average number of drugs per trimester among women who were prescribed drugs was two (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The prescription rate increased from 43.6 per 100 women in the first trimester to 49.3 and 60.8 per 100 women in the second and third trimester of pregnancy.…”

Section: Resultsmentioning

confidence: 99%

Maternal medicine: Drug prescription patterns before, during and after pregnancy for chronic, occasional and pregnancy‐related drugs in the Netherlands

Bakker¹,

Jentink²,

Vroom³

et al. 2006

BJOG

163

158

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Objective To compare the prescription of drugs in women over a period from 2 years before until 3 months after pregnancy, regarding the type of drugs used and the fetal risk.Design A cohort study based on pharmacy records of women giving birth to a child between 1994 and 2003.Setting The study was performed with data from the InterAction database, containing prescription-drug-dispensing data from community pharmacies.Population The study population included 5412 women for whom complete pharmacy records were available.Methods Drugs were classified into three categories: (1) drugs for chronic conditions, (2) drugs for occasional use and (3) drugs for pregnancy-related symptoms and also classified according to the Australian classification system.Main outcome measures The prescription rate was calculated as the number of women per 100 women who received one or more prescriptions for a given drug within a specified time period.Results About 79.1% of the women received at least one prescription during pregnancy. The prescription rate for most drugs for chronic diseases and for occasional use decreased during pregnancy, whereas, as expected, the prescription rate for pregnancy-related drugs increased. During the first trimester of pregnancy, 1.7% of all drugs prescribed for chronic conditions and 2.3% of the occasional drugs were classified as harmful.Conclusions The increase in prescription rate during pregnancy is caused by an increase in prescription rate of drugs for pregnancyrelated symptoms. The prescription of harmful drugs is more commonly associated with drugs for occasional use rather than with drugs for chronic conditions. Therefore, a more cautious prescribing of drugs to healthy women in the fertile age is necessary.Keywords Drug utilisation, fetal risk classification, pregnancy, prescription rate, register based.Please cite this paper as: Bakker M, Jentink J, Vroom F, Van Den Berg P, De Walle H, De Jong-Van Den Berg L. Drug prescription patterns before, during and after pregnancy for chronic, occasional and pregnancy-related drugs in the Netherlands. BJOG 2006; 113:559-568. IntroductionSince the teratogenic risk of most drugs is still undetermined, it is important to monitor drug use regularly among pregnant women. Drug-utilisation studies reveal that most women use drugs during pregnancy, with estimations varying from 44 1 to 99%. 2 However, comparison is difficult because of differences in study design. Interviews or prescription databases may be used for collecting drug-use data, and the type of drugs studied may or may not include over-the-counter (OTC) drugs such as vitamins, iron and analgesics. Most studies found an increasing trend in drug use during pregnancy. [2][3][4][5][6][7] Drug use cannot be always avoided during pregnancy. For women with certain chronic medical conditions such as epilepsy, diabetes, inflammatory bowel disease and asthma, the use of drugs is essential, and benefits for mother and child may well outweigh the teratogenic risk of the drug. 8,9 Other nonchronic diseases relate...

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“…[1][2][3] Pregnancy induced hypertension affects 6% to 8% of pregnant women and has serious consequences for the mother and child. 4 An association between asthma and pregnancy induced hypertension has been reported, 2 5-10 but it is still unclear whether this was due to the drugs used to treat asthma or to the asthma itself.…”

Section: Introductionmentioning

confidence: 99%

Use of Inhaled Corticosteroids During Pregnancy and Risk of Pregnancy-Induced Hypertension: Nested Case???Control Study

Martel

Rey

Beauchesne

et al. 2005

Obstetrical & Gynecological Survey

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Objective To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women. Design Nested case-control study. Setting Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des événements démographiques. Participants 3505 women with asthma, totalling 4593 pregnancies, between 1990 and 2000. Main outcome measures Pregnancy induced hypertension and pre-eclampsia. Results 302 cases of pregnancy induced hypertension and 165 cases of pre-eclampsia were identified. Use of inhaled corticosteroids from conception until date of outcome was not associated with an increased risk of pregnancy induced hypertension (adjusted odds ratio 1.02, 95% confidence interval 0.77 to 1.34) or pre-eclampsia (1.06, 0.74 to 1.53). No significant dose-response relation was observed between inhaled corticosteroids and pregnancy induced hypertension or pre-eclampsia. Oral corticosteroids were significantly associated with the risk of pregnancy induced hypertension (adjusted odds ratio 1.57, 1.02 to 2.41), and a trend was seen for pre-eclampsia (1.72, 0.98 to 3.02). Conclusion No significant increase of the risk of pregnancy-induced hypertension or preeclampsia was detected among users of inhaled corticosteroids during pregnancy, while markers of uncontrolled and severe asthma were found to significantly increase the risks of pregnancy-induced hypertension and pre-eclampsia.

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Drug use in first pregnancy and lactation: a population-based survey among Danish women

Cited by 137 publications

References 22 publications

Consumo de medicamentos no período de internação para o parto

Consumo de medicamentos no período de internação para o parto

Maternal medicine: Drug prescription patterns before, during and after pregnancy for chronic, occasional and pregnancy‐related drugs in the Netherlands

Use of Inhaled Corticosteroids During Pregnancy and Risk of Pregnancy-Induced Hypertension: Nested Case???Control Study

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