Medication prescribing and pregnancy-related risk factors for women with type 2 diabetes of reproductive age within primary care: a cross-sectional investigation for the PREPARED study.
Alexandra M Famiglietti, Judith Parsons, Kia-Chong Chua, Anna Hodgkinson, Olubunmi Abiola, Anna Brackenridge, Anita Banerjee, Mark Chamley, Lily Hopkins, Katharine F Hunt, Helen Murphy, Helen Rogers, Gavin Steele, Kirsty Winkley, Angus Forbes, Rita Forde
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Abstract
Introduction: Women with type 2 diabetes are at risk of commencing pregnancy while using medications that are either not recommended for pregnancy or with known teratogenicity, which may contribute to adverse pregnancy outcomes. In this study, we aimed to characterize pregnancy-related risk factors and medication exposures among women with type 2 diabetes.
Research design and methods: Individual health characteristics, sociodemographic information, and prescription data were extracted from the primary care records of women aged 18-45 years with type 2 diabetes in participating general practices in the UK. Prescribed medications were categorized according to suitability for pregnancy: recommended, not recommended, or not recommended but used if clinically indicated. Logistic regression was used to estimate associations between individual characteristics and medications not recommended for pregnancy.
Results: Data on 725 women were extracted. Prescribed medications suggested the presence of numerous comorbidities, with diabetes medications (65%, n=471) and statins (20%, n=145) most frequently prescribed. 37% (n=268) of women took ≥3 medications, and a third (n=269) took medications not recommended for pregnancy. Among those not prescribed contraception (89%, n=646), no one met all clinically recommended pre-pregnancy criteria. In multivariable logistic regression analysis, polypharmacy (OR 3.49 95% CI 2.88 to 4.30) and age (OR 1.04 95% CI 1.00 to 1.09) were associated with use of medications not recommended for pregnancy.
Conclusions: Women with type 2 diabetes have suboptimal contraceptive provision despite multiple exposures to medications not recommended for pregnancy. Regular assessment of contraceptive use, reproductive intentions, and medication review is urgently needed in primary care settings to minimize pregnancy-related risks.
期刊介绍：
BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of
high-quality — and evidence-based — original research articles.
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