Monitoring medicine prescriptions before, during and after pregnancy in Italy

Abstract

Background The use of medications during pregnancy is a common event worldwide. Monitoring medicine prescriptions in clinical practice is a necessary step in assessing the impact of therapeutic choices in pregnant women as well as the adherence to clinical guidelines. The aim of this study was to provide prevalence data on medication use before, during and after pregnancy in the Italian population. Methods A retrospective prevalence study using administrative healthcare databases was conducted. A cohort of 449,012 pregnant women (15–49 years) residing in eight Italian regions (59% of national population), who delivered in 2016–2018, were enrolled. The prevalence of medication use was estimated as the proportion (%) of pregnant women with any prescription. Results About 73.1% of enrolled women received at least one drug prescription during pregnancy, 57.1% in pre-pregnancy and 59.3% in postpartum period. The prevalence of drug prescriptions increased with maternal age, especially during the 1st trimester of pregnancy. The most prescribed medicine was folic acid (34.6%), followed by progesterone (19%), both concentrated in 1st trimester of pregnancy (29.2% and 14.8%, respectively). Eight of the top 30 most prescribed medications were antibiotics, whose prevalence was higher during 2nd trimester of pregnancy in women ≥ 40 years (21.6%). An increase in prescriptions of anti-hypertensives, antidiabetics, thyroid hormone and heparin preparations was observed during pregnancy; on the contrary, a decrease was found for chronic therapies, such as anti-epileptics or lipid-modifying agents. Conclusions This study represents the largest and most representative population-based study illustrating the medication prescription patterns before, during and after pregnancy in Italy. The observed prescriptive trends were comparable to those reported in other European countries. Given the limited information on medication use in Italian pregnant women, the performed analyses provide an updated overview of drug prescribing in this population, which can help to identify critical aspects in clinical practice and to improve the medical care of pregnant and childbearing women in Italy.

Drug Prescriptions during Pregnancy in Lombardy: Temporal Trends and the Impact of the Onset of the COVID-19 Pandemic

“…As regards the most prescribed drugs, our observation was consistent with previous cohort studies [6][7][8][9][10]. Folic acid, ferrous sulfate, progesterone, and selected antibiotics represented the most used medication during pregnancy.…”

“…Pharmacoepidemiology 2023, 2, FOR PEER REVIEW 2 [5]. In Italy, automated databases have been used to investigate drug utilization in pregnancy, providing detailed prescription information collected prospectively for large cohorts of pregnant women from different regions [6][7][8][9]. In 2020, for the first time, the Italian Medicines Agency (AIFA) published a report based on the linkage record of different regional health information flows [10,11].…”

“…Interview-based studies provided the first results on the use of drugs during pregnancy in Italy; women who reported taking at least one drug during pregnancy ranged from 55% to 80% [12][13][14]. More recently, cohort studies using automated administrative databases were conducted in different regions of Italy [6][7][8][9].…”

“…Research on drug utilization during pregnancy has shown that up to 27-99% of pregnant women take at least one medication if also considering the consumption of vitamins and minerals, with a substantial number of drugs with a hazardous risk profile [5]. In Italy, automated databases have been used to investigate drug utilization in Pharmacoepidemiology 2023, 2 250 pregnancy, providing detailed prescription information collected prospectively for large cohorts of pregnant women from different regions [6][7][8][9]. In 2020, for the first time, the Italian Medicines Agency (AIFA) published a report based on the linkage record of different regional health information flows [10,11].…”

Antidiabetic Therapy during Pregnancy: The Prescription Pattern in Italy

“…We could not include voluntary and spontaneous abortions, as those data are not recorded in the CeDAP database. We selected 449,012 women, age ranging from 15 to 49 years old, from the eight Italian Regions who delivered in hospital between 1 April 2016 and 31 March 2018 (Table 1) [33]. We could not include voluntary and spontaneous abortions, as those data are not recorded in the CeDAP database.…”