| アブストラクト | BACKGROUND: The number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy. METHODS: A retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register. Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period. Logistic regression models were performed to identify risk factors for polypharmacy. RESULTS: During the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%. Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs). Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14-1.18) and 1.55 (1.53-1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33-2.47), 1.71 (1.65-1.76), 1.41 (1.35-1.47) and 1.39 (1.30-1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18-1.20) and 1.05 (1.03-1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy. CONCLUSIONS: The prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus. |
|---|
| 投稿者 | Subramanian, Anuradhaa; Azcoaga-Lorenzo, Amaya; Anand, Astha; Phillips, Katherine; Lee, Siang Ing; Cockburn, Neil; Fagbamigbe, Adeniyi Francis; Damase-Michel, Christine; Yau, Christopher; McCowan, Colin; O'Reilly, Dermot; Santorelli, Gillian; Hope, Holly; Kennedy, Jonathan I; Abel, Kathryn M; Eastwood, Kelly-Ann; Locock, Louise; Black, Mairead; Loane, Maria; Moss, Ngawai; Plachcinski, Rachel; Thangaratinam, Shakila; Brophy, Sinead; Agrawal, Utkarsh; Vowles, Zoe; Brocklehurst, Peter; Dolk, Helen; Nelson-Piercy, Catherine; Nirantharakumar, Krishnarajah |
|---|
| 組織名 | Institute of Applied Health Research, University of Birmingham, Birmingham, B15;2TT, UK.;Division of Population and Behavioural Sciences, School of Medicine, University;of St Andrews, St Andrews, UK.;2TT, UK. k.phillips.1@bham.ac.uk.;Department of Epidemiology and Medical Statistics, College of Medicine,;University of Ibadan, Ibadan, Nigeria.;Medical and Clinical Pharmacology, School of Medicine, Universite Toulouse III,;Toulouse, France.;INSERM, Center for Epidemiology and Research in Population Health (CERPOP),;Toulouse, CIC 1436, France.;Division of Informatics, Imaging and Data Sciences, Faculty of Biology Medicine;and Health, The University of Manchester, Manchester, UK.;Health Data Research UK, Oxford, UK.;Centre for Public Health, Queen's University of Belfast, Belfast, UK.;Bradford Institute for Health Research, Bradford, UK.;Centre for Women's Mental Health, Division of Psychology and Mental Health,;School of Health Sciences, Faculty of Biology Medicine & Health, The University;of Manchester, Manchester, UK.;Data Science, Medical School, Swansea University, Swansea, UK.;Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.;St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust,;Bristol, UK.;Health Services Research Unit, School of Medicine, Medical Science and Nutrition,;University of Aberdeen, Aberdeen, UK.;Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science;and Nutrition, University of Aberdeen, Aberdeen, UK.;Centre for Maternal, Fetal and Infant Research, The Institute of Nursing and;Health Research, Ulster University, Coleraine, UK.;Patient and Public Representative, London, UK.;WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and;Systems Research, University of Birmingham, Birmingham, UK.;Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS;Foundation Trust, Birmingham, UK.;Guy's and St. Thomas' NHS Foundation Trust, London, UK. |
|---|
