Caroline Hurault-Delarue1, Joan K Morris2, Rachel Charlton3, Rosa Gini4, Maria Loane5, Anna Pierini6, Aurora Puccini7, Amanda Neville8, Julia Snowball3, Christine Damase-Michel1. 1. Pharmacologie Faculté de Médecine, Université Paul-Sabatier Toulouse III CHU Toulouse, UMR INSERM, Toulouse, 1027, France. 2. Population Health Research Institute, St George's, University of London, St George's, University of London, London, UK. 3. Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. 4. Agenzia Regionale di Sanità della Toscana, Florence, Italy. 5. Centre for Maternal, Fetal and Infant Research, INHR, Ulster University, Newtowanbbey, UK. 6. Institute of Clinical Physiology-National Research Council (IFC-CNR)/Fondazione Toscana "Gabriele Monasterio", Pisa, Italy. 7. Drug Policy Service, Emilia Romagna Region Health Authority, Bologna, Italy. 8. IMER (Emilia Romagna Registry of Birth Defects), Centre for Clinical and Epidemiological Research, University of Ferrara and Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
Abstract
PURPOSE: To study patterns of antiepileptic drugs (AED) prescribing, particularly valproate, during pregnancy over a 10-year period in the UK, Italy, and France. METHODS: Data on pregnancies conceived after 1 January 2007 with outcomes before 31 December 2016 were extracted from four European electronic health care databases (380 499 in the United Kingdom (UK), 66 681 in France, and 649 918 in Italy [355 767 in Emilia Romagna and 294 151 in Tuscany]). Prevalence of AEDs with an ATC code starting N03A and clobazam (N05BA09) were stratified by country and calendar year. RESULTS: AED prescribing during pregnancy varied from 3.0 (2.8-3.1) per 1000 pregnancies in Emilia Romagna to 7.8 (7.5-8.0) in the UK, 5.9 (5.6-6.1) in Tuscany, and 6.3 (5.7-6.9) in France. Lamotrigine was commonly prescribed in all regions with a third of women exposed to an AED during pregnancy taking lamotrigine in the UK and France. Valproate was prescribed to 28.6% of AED exposed pregnant women in Tuscany, 21.6% in France, 16.7% in Emilia Romagna, and 11.9% in the UK. Over the study period, the prevalence of AED prescribing increased in the UK mainly due to increases in pregabalin and gabapentin, declined in France mainly related to decreases in clonazepam, and remained constant in Italy. Valproate prescriptions declined to a prevalence <1 per 1000 pregnancies in 2015 to 2016 in the UK, France, and Emilia Romagna. CONCLUSIONS: Variations in AED prescribing during pregnancy indicate the potential for further reductions, particularly of valproate. Increases in pregabalin/gabapentin prescribing, for which risks are not well known, are a cause for concern.
PURPOSE: To study patterns of antiepileptic drugs (AED) prescribing, particularly valproate, during pregnancy over a 10-year period in the UK, Italy, and France. METHODS: Data on pregnancies conceived after 1 January 2007 with outcomes before 31 December 2016 were extracted from four European electronic health care databases (380 499 in the United Kingdom (UK), 66 681 in France, and 649 918 in Italy [355 767 in Emilia Romagna and 294 151 in Tuscany]). Prevalence of AEDs with an ATC code starting N03A and clobazam (N05BA09) were stratified by country and calendar year. RESULTS: AED prescribing during pregnancy varied from 3.0 (2.8-3.1) per 1000 pregnancies in Emilia Romagna to 7.8 (7.5-8.0) in the UK, 5.9 (5.6-6.1) in Tuscany, and 6.3 (5.7-6.9) in France. Lamotrigine was commonly prescribed in all regions with a third of women exposed to an AED during pregnancy taking lamotrigine in the UK and France. Valproate was prescribed to 28.6% of AED exposed pregnant women in Tuscany, 21.6% in France, 16.7% in Emilia Romagna, and 11.9% in the UK. Over the study period, the prevalence of AED prescribing increased in the UK mainly due to increases in pregabalin and gabapentin, declined in France mainly related to decreases in clonazepam, and remained constant in Italy. Valproate prescriptions declined to a prevalence <1 per 1000 pregnancies in 2015 to 2016 in the UK, France, and Emilia Romagna. CONCLUSIONS: Variations in AED prescribing during pregnancy indicate the potential for further reductions, particularly of valproate. Increases in pregabalin/gabapentin prescribing, for which risks are not well known, are a cause for concern.
Authors: Stuart McTaggart; Gavin MacColl; Karen Gronkowski; Rachael Wood; John Paul Leach; Marion Bennie Journal: BMJ Open Date: 2022-04-13 Impact factor: 3.006
Authors: Richard H Finnell; Carlo Donato Caiaffa; Sung-Eun Kim; Yunping Lei; John Steele; Xuanye Cao; Gabriel Tukeman; Ying Linda Lin; Robert M Cabrera; Bogdan J Wlodarczyk Journal: Front Genet Date: 2021-05-10 Impact factor: 4.599