The Use of Multiple Medications During Pregnancy Among an Ethnically Diverse Population in South-Eastern Melbourne: A Retrospective Analysis to Explore Potential Risks and Complications.

IF 4 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Yitayeh Belsti, Aya Mousa, Hannah Jackson, Lisa J Moran, Kirsten R Palmer, Raja Ram Dhungana, Emily Callander, Daniel Lorber Rolnik, Helena Teede, Joanne Enticott
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Abstract

Background and objective: Medication use is increasing to treat both pre-existing and pregnancy-related medical conditions or complications. This study aims to investigate factors associated with multiple medication use during pregnancy, as well as any increased risk of pregnancy complications for women taking multiple medications.

Methods: A retrospective analysis of routinely collected medical records of singleton pregnant women was conducted in Southeast Melbourne, Australia, between 2016 and 2021. Self-reported medication use was recorded as part of routine medical care, starting from the first antenatal booking appointment and continuing for every subsequent antenatal appointment until birth. Multimorbidity was defined as having two or more medical conditions. Logistic regression was used to assess factors influencing multiple medication use (defined as taking two or more non-supplemental medications at any stage of pregnancy) and associations with pregnancy complications.

Results: Of 48,502 participants, 34.9% used one medication, while 11.7% used multiple medications. Women of older age (30-34, 35-39, and ≥  40 years), higher body mass index (25.0-29.9 kg/m2 and ≥  30 kg/m2), born in Australasia and Oceania, higher socioeconomic status, and multimorbidity were more likely to use multiple medications during pregnancy. Women taking multiple medications had a higher risk of preterm and caesarean deliveries, fetal death, and neonatal admissions to intensive care. Sensitivity analyses exploring different morbidity categories produced no changes to findings.

Conclusions: Medication use during pregnancy is prevalent, with many pregnant mothers taking multiple medications. Given the rising maternal age, body mass index, and morbidities in pregnancy, the use of medications during pregnancy is increasing. Such use correlates with an increased chance of adverse pregnancy outcomes. In the context of limited trials on the safety and efficacy of medications in pregnancy, timely harnessing of the information available within routine medical records for post-marketing surveillance is important.

墨尔本东南部不同种族人群在怀孕期间使用多种药物的情况:探索潜在风险和并发症的回顾性分析。
背景和目的:越来越多的妇女使用药物来治疗原有的和与妊娠有关的疾病或并发症。本研究旨在调查与孕期多次用药相关的因素,以及服用多种药物的妇女发生妊娠并发症的风险是否会增加:方法:2016 年至 2021 年期间,在澳大利亚墨尔本东南部对常规收集的单胎孕妇医疗记录进行了回顾性分析。作为常规医疗护理的一部分,从首次产前预约开始,并在随后的每次产前预约中记录自我报告的药物使用情况,直至分娩。多病的定义是患有两种或两种以上的疾病。采用逻辑回归法评估多种药物使用的影响因素(定义为在妊娠的任何阶段服用两种或两种以上非补充性药物)以及与妊娠并发症的关系:在 48 502 名参与者中,34.9% 使用一种药物,11.7% 使用多种药物。年龄较大(30-34 岁、35-39 岁和≥40 岁)、体重指数较高(25.0-29.9 kg/m2 和≥30 kg/m2)、出生在澳大拉西亚和大洋洲、社会经济地位较高和患有多种疾病的妇女更有可能在怀孕期间使用多种药物。服用多种药物的妇女早产、剖腹产、胎儿死亡和新生儿入住重症监护室的风险较高。对不同发病率类别进行的敏感性分析没有改变研究结果:结论:孕期用药非常普遍,许多孕产妇服用多种药物。鉴于孕产妇年龄、体重指数和孕期发病率的上升,孕期用药量也在增加。孕期用药会增加不良妊娠结局的发生几率。在妊娠期用药安全性和有效性试验有限的情况下,及时利用常规医疗记录中的信息进行上市后监测非常重要。
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来源期刊
Drug Safety
Drug Safety 医学-毒理学
CiteScore
7.60
自引率
7.10%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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