BACKGROUND: Medication use during pregnancy and lactation is prevalent. However, current knowledge of the risks and benefits of medication use during pregnancy and lactation is incomplete as the best available evidence has been obtained from cohort studies of inadvertent exposures and registries. This situation may partly explain health care providers' (HCP) risk perceptions and thus the increasing number of calls to Teratogen Information Services (TIS). OBJECTIVES: The objectives of this study were (1) to identify the medication classes for which HCP are seeking counseling from the IMAGe center, a Quebec TIS; (2) to identify the medical conditions for which medication classes were used during pregnancy and lactation; (3) to identify and quantify predictors of medication information requests during pregnancy and lactation. METHODS: A retrospective analysis of data was conducted within the population served by the IMAGe center, a TIS based at CHU Ste-Justine in Montreal, Quebec, Canada, that serves the French population of Canada. To be included, calls had to be received between January 1, 2004 and April 30, 2007, and the subject of the call had to be directly associated with the exposure, or not, of a pregnant or breastfeeding woman to medication. Multivariate generalized estimating equation (GEE) regression models were performed to identify the predictors of medication requests. RESULTS: A total of 11, 076 requests regarding medication exposure during pregnancy, 12 055 requests regarding pregnant women before the exposure took place, and 13, 364 requests regarding lactation were included for analyses. Pregnant women were most frequently exposed to antidepressants (17.3), antibiotics (6.3%), and benzodiazepines (5.3%). Prior to drug exposure, the most frequent inquiries by HCP were on antibiotics (11.0%), anti-inflammatory drugs (6.0%), and antiemetics (5.1%). Inquiries concerning lactating women most frequently requested information on the drug classes of antidepressants (10.8%), antibiotics (9.1%), and anti-inflammatory drugs (7.8%). Depressive disorders were an indication of antidepressant, benzodiazepine and antipsychotic exposures reported to IMAGe. Associations were found between medication use and maternal age, previous pregnancies, trimester of pregnancy at the time of the call and lifestyle habits. CONCLUSIONS: The IMAGe received frequent inquiries on antidepressant, antibiotic, and benzodiazepine exposures, with depressive disorders being the most frequently declared indication. Predictors of medication requests were identified among exposed women during pregnancy, and breastfeeding women. These results emphasize the need for effective studies on drug use during pregnancy and lactation and for better knowledge transfer programs.
BACKGROUND: Medication use during pregnancy and lactation is prevalent. However, current knowledge of the risks and benefits of medication use during pregnancy and lactation is incomplete as the best available evidence has been obtained from cohort studies of inadvertent exposures and registries. This situation may partly explain health care providers' (HCP) risk perceptions and thus the increasing number of calls to Teratogen Information Services (TIS). OBJECTIVES: The objectives of this study were (1) to identify the medication classes for which HCP are seeking counseling from the IMAGe center, a Quebec TIS; (2) to identify the medical conditions for which medication classes were used during pregnancy and lactation; (3) to identify and quantify predictors of medication information requests during pregnancy and lactation. METHODS: A retrospective analysis of data was conducted within the population served by the IMAGe center, a TIS based at CHU Ste-Justine in Montreal, Quebec, Canada, that serves the French population of Canada. To be included, calls had to be received between January 1, 2004 and April 30, 2007, and the subject of the call had to be directly associated with the exposure, or not, of a pregnant or breastfeeding woman to medication. Multivariate generalized estimating equation (GEE) regression models were performed to identify the predictors of medication requests. RESULTS: A total of 11, 076 requests regarding medication exposure during pregnancy, 12 055 requests regarding pregnant women before the exposure took place, and 13, 364 requests regarding lactation were included for analyses. Pregnant women were most frequently exposed to antidepressants (17.3), antibiotics (6.3%), and benzodiazepines (5.3%). Prior to drug exposure, the most frequent inquiries by HCP were on antibiotics (11.0%), anti-inflammatory drugs (6.0%), and antiemetics (5.1%). Inquiries concerning lactating women most frequently requested information on the drug classes of antidepressants (10.8%), antibiotics (9.1%), and anti-inflammatory drugs (7.8%). Depressive disorders were an indication of antidepressant, benzodiazepine and antipsychotic exposures reported to IMAGe. Associations were found between medication use and maternal age, previous pregnancies, trimester of pregnancy at the time of the call and lifestyle habits. CONCLUSIONS: The IMAGe received frequent inquiries on antidepressant, antibiotic, and benzodiazepine exposures, with depressive disorders being the most frequently declared indication. Predictors of medication requests were identified among exposed women during pregnancy, and breastfeeding women. These results emphasize the need for effective studies on drug use during pregnancy and lactation and for better knowledge transfer programs.
Authors: C Olesen; F H Steffensen; G L Nielsen; L de Jong-van den Berg; J Olsen; H T Sørensen Journal: Eur J Clin Pharmacol Date: 1999-04 Impact factor: 2.953
Authors: Jerrie S Refuerzo; Sean C Blackwell; Robert J Sokol; Lorraine Lajeunesse; Katherine Firchau; Michael Kruger; Yoram Sorokin Journal: Am J Perinatol Date: 2005-08 Impact factor: 1.862
Authors: C De Vigan; H E De Walle; S Cordier; J Goujard; R Knill-Jones; S Aymé; E Calzolari; F Bianchi Journal: J Clin Epidemiol Date: 1999-10 Impact factor: 6.437
Authors: Debra L Bogen; James M Perel; Joseph C Helsel; Barbara H Hanusa; Matthew Thompson; Katherine L Wisner Journal: Breastfeed Med Date: 2011-02-24 Impact factor: 1.817
Authors: Lavinia Schüler-Faccini; Maria Teresa Vieira Sanseverino; Alberto Mantovani Abeche; Fernanda Sales Luiz Vianna; Lucas Rosa Fraga; Anastacia Guimaraes Rocha; André Anjos da Silva; Paulo Ricardo Assis de Souza; Artur Hartmann Hilgert; Camila Pocharski Barbosa; Caroline Grasso Kauppinem; Daniela Fernandes Martins; Daniela Silva Santos; Gabriel Henrique Colpes; Gabriela Ecco; Helena Margot Flores Soares da Silva; Louise Piva Penteado; Tatiane Dos Santos Journal: Genet Mol Biol Date: 2019-04-11 Impact factor: 1.771
Authors: Aikaterini Zafeiri; Edwin Amalraj Raja; Rod Thomas Mitchell; David C Hay; Sohinee Bhattacharya; Paul A Fowler Journal: BMJ Open Date: 2022-05-03 Impact factor: 3.006
Authors: Sarah C Campbell; Tyler T Kast; Manijeh Kamyar; Julia Robertson; Catherine M Sherwin Journal: BMC Pharmacol Toxicol Date: 2016-07-23 Impact factor: 2.483