Pharmacoepidemiologic Evaluation of Birth Defects from Health-Related Postings in Social Media During Pregnancy

Abstract

IntroductionAdverse effects of medications taken during pregnancy are traditionally studied through post-marketing pregnancy registries, which have limitations. Social media data may be an alternative data source for pregnancy surveillance studies.ObjectiveThe objective of this study was to assess the feasibility of using social media data as an alternative source for pregnancy surveillance for regulatory decision making.MethodsWe created an automated method to identify Twitter accounts of pregnant women. We identified 196 pregnant women with a mention of a birth defect in relation to their baby and 196 without a mention of a birth defect in relation to their baby. We extracted information on pregnancy and maternal demographics, medication intake and timing, and birth defects.ResultsAlthough often incomplete, we extracted data for the majority of the pregnancies. Among women that reported birth defects, 35% reported taking one or more medications during pregnancy compared with 17% of controls. After accounting for age, race, and place of residence, a higher medication intake was observed in women who reported birth defects. The rate of birth defects in the pregnancy cohort was lower (0.44%) compared with the rate in the general population (3%).ConclusionsTwitter data capture information on medication intake and birth defects; however, the information obtained cannot replace pregnancy registries at this time. Development of improved methods to automatically extract and annotate social media data may increase their value to support regulatory decision making regarding pregnancy outcomes in women using medications during their pregnancies.

Assessment of Beliefs and Attitudes About Statins Posted on Twitter

“…People who post about statins on social media may not be representative of the population of statin users, and people will be selective on what they choose to post. It is already known that social media users tend to be younger [54][55][56] and that statins are used in an older population. The median age of a US Twitter user is 40 years vs the median age of a US adult, which is 47 years.…”

Pregnancy and health in the age of the Internet: A content analysis of online “birth club” forums

“…An alternate approach to studying how women utilize the Internet during pregnancy is to examine the online content that women generate. Our prior work focused on gathering pregnancy-related information from a generic social media platform such as Twitter, whereby a cohort of pregnant women was identified via their self-reports of pregnancy and their timelines (all publicly available tweets) during pregnancy were analyzed in a case-control study of birth defects [25][26][27]. Other researchers have identified pregnant women based on their search queries, and determined their time-dependent search queries throughout pregnancy [28].…”

“…At present, the most active discussion boards on pregnancy forums are due-date specific, (also known as "birth clubs"), where expectant mothers can connect with a community of peers undergoing a similar chronological pregnancy journey. [27] Based on publicly available data from WhatToExpect.com and BabyCenter.com, we estimate that there are currently over one million total posts (initial posts + replies) for each birth club forum (i.e., for each due date month and year, such as April 2019) across these two websites. Though the grounded theory approach utilized by Gui et al (2017) offered researchers deep immersion in the data, it would be infeasible to manually code the hundreds of thousands of posts that comprise each birth club forum.…”

An empirical evaluation of electronic annotation tools for Twitter data

“…GATE is an open-source toolkit developed for text annotation and automatic text processing. We used the stand-alone version of GATE to annotate Twitter timelines for prior projects [18]. Although a web-based version of GATE is available, GATE teamware [19], we compared TextAE with the stand-alone version of GATE, as we were already familiar with the tool and it was easier to install during the hackathon than the web-based version.…”