| アブストラクト | OBJECTIVE: To compare patterns in use of different antiemetics during pregnancy in Canada, the United Kingdom, and the United States, between 2002 and 2014. METHODS: We constructed population-based cohorts of pregnant women using administrative healthcare data from five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, and Saskatchewan), the Clinical Practice Research Datalink from the United Kingdom, and the IBM MarketScan Research Databases from the United States. We included pregnancies ending in live births, stillbirth, spontaneous abortion, or induced abortion. We determined maternal use of antiemetics from pharmacy claims in Canada and the United States and from prescriptions in the United Kingdom. RESULTS: The most common outcome of 3 848 734 included pregnancies (started 2002-2014) was live birth (66.7% of all pregnancies) followed by spontaneous abortion (20.2%). Use of antiemetics during pregnancy increased over time in all three countries. Canada had the highest prevalence of use of prescription antiemetics during pregnancy (17.7% of pregnancies overall, 13.2% of pregnancies in 2002, and 18.9% in 2014), followed by the United States (14.0% overall, 8.9% in 2007, and 18.1% in 2014), and the United Kingdom (5.0% overall, 4.2% in 2002, and 6.5% in 2014). Besides use of antiemetic drugs being considerably lower in the United Kingdom, the increase in its use over time was more modest. The most commonly used antiemetic was combination doxylamine/pyridoxine in Canada (95.2% of pregnancies treated with antiemetics), ondansetron in the United States (72.2%), and prochlorperazine in the United Kingdom (63.5%). CONCLUSIONS: In this large cohort study, we observed an overall increase in antiemetic use during pregnancy, and patterns of use varied across jurisdictions. Continued monitoring of antiemetic use and further research are warranted to better understand the reasons for differences in use of these medications and to assess their benefit-risk profile in this population. |
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| 投稿者 | Fisher, Anat; Paterson, J Michael; Winquist, Brandace; Wu, Fangyun; Reynier, Pauline; Suissa, Samy; Dahl, Matthew; Ma, Zhihai; Lu, Xinya; Zhang, Jianguo; Raymond, Colette B; Filion, Kristian B; Platt, Robert W; Moriello, Carolina; Dormuth, Colin R |
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| 組織名 | Faculty of Medicine, Department of Anesthesiology, Pharmacology and Therapeutics,;University of British Columbia, Vancouver, British Columbia, Canada.;ICES, Toronto, Ontario, Canada.;Institute of Health Policy, Management and Evaluation, University of Toronto,;Toronto, Ontario, Canada.;College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.;Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada.;Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;Montreal, Quebec, Canada.;Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Quebec, Canada.;Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba,;Canada.;Department of Medicine, Cumming School of Medicine, University of Calgary,;Calgary, Alberta, Canada.;Department of Medicine, McGill University, Montreal, Quebec, Canada.;Department of Pediatrics, McGill University, Montreal, Quebec, Canada. |
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