Real-World Assessment of Psychotropic and Antiepileptic Drug Use During Pregnancy in Belgium: Trends, Predictors, and Comparative Risk of Congenital Anomalies (2010-2016).

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2024-10-01 DOI:10.1002/pds.70021

Lionel Larcin, Calypse Ngwasiri, Anouk Neven, Christine Damase-Michel, Fati Kirakoya-Samadoulougou

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引用次数: 0

Abstract

Purpose: To analyze the prescription patterns and sociodemographic factors associated with the use of antipsychotic, antidepressant, and antiepileptic drugs during pregnancy in Belgium, and to investigate their potential association with congenital anomalies.

Methods: Using a nationwide linked database, we identified antidepressants, antipsychotics, and antiepileptics via the Anatomical Therapeutic and Chemical Classification (ATC) codes. For each medication group, we calculated the overall prevalence and prevalence for the three most used medications at the fifth ATC level. Sociodemographic factors influencing medication use during pregnancy were analyzed, and potential associations with congenital anomalies were investigated through logistic regression models based on generalized estimating equations.

Results: Overall, 828 016 live births pregnancies associated with 611 094 mothers were identified. We found that the use of antidepressants, antipsychotics, and antiepileptics was decreasing with the arrival of pregnancy. Mothers with a less favorable sociodemographic status were more likely to be exposed to these medications. Antiepileptics used in the first trimester were associated with an increased risk of congenital anomalies (aOR = 1.65, 95% CI 1.11-2.45) compared with unexposed women. The three most used antiepileptics were lamotrigine, valproate, and levetiracetam, among them, we found an association with congenital anomalies only for valproate (aOR = 3.92, 95% CI 2.30-6.67).

Conclusions: Psychotropic and antiepileptic drug use decreased during pregnancy. Pregnant women with a less favorable sociodemographic status were more likely to be exposed to psychotropics and antiepileptics during pregnancy. The elevated risk of congenital anomalies associated with antiepileptics use, particularly valproate, underscores the need for targeted interventions and increased awareness to improve maternal and fetal health outcomes.

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比利时妊娠期精神药物和抗癫痫药物使用的真实世界评估：比利时妊娠期精神药物和抗癫痫药物使用的真实世界评估：趋势、预测因素和先天畸形的比较风险（2010-2016 年）》。

目的：分析比利时孕妇在怀孕期间使用抗精神病药、抗抑郁药和抗癫痫药的处方模式和相关社会人口因素，并研究它们与先天性畸形的潜在关联：我们利用一个全国联网的数据库，通过解剖学治疗和化学分类（ATC）代码确定了抗抑郁药、抗精神病药和抗癫痫药。对于每个药物组别，我们计算了总体患病率以及在 ATC 第五级中最常用的三种药物的患病率。我们分析了影响孕期用药的社会人口学因素，并通过基于广义估计方程的逻辑回归模型研究了与先天性畸形的潜在关联：结果：共发现了 828 016 例活产妊娠，涉及 611 094 名母亲。我们发现，抗抑郁药、抗精神病药和抗癫痫药的使用随着妊娠的到来而减少。社会人口状况较差的母亲更有可能接触到这些药物。与未接触过这些药物的妇女相比，在妊娠头三个月使用抗癫痫药物会增加先天性畸形的风险（aOR = 1.65，95% CI 1.11-2.45）。使用最多的三种抗癫痫药物是拉莫三嗪、丙戊酸钠和左乙拉西坦，其中我们发现只有丙戊酸钠与先天性畸形有关（aOR = 3.92，95% CI 2.30-6.67）：妊娠期精神药物和抗癫痫药物的使用有所减少。结论：妊娠期精神药物和抗癫痫药物的使用有所减少，社会人口状况较差的孕妇在妊娠期更有可能接触精神药物和抗癫痫药物。与使用抗癫痫药（尤其是丙戊酸钠）相关的先天性畸形风险升高，凸显了有必要采取有针对性的干预措施并提高人们的认识，以改善孕产妇和胎儿的健康状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.