Document Detail

Prescriptions for contraindicated category X drugs in pregnancy among women enrolled in TennCare.
MedLine Citation:
PMID:  14996249     Owner:  NLM     Status:  MEDLINE    
Filling of prescriptions for medications labelled as category X by the United States Food and Drug Administration (considered to be contraindicated for use in pregnancy) was identified among 95 284 women enrolled in TennCare, Tennessee's programme for Medicaid enrollees and individuals without health insurance. Using administrative claims data, 391 women (4.10/1000) were identified as having filled category X prescriptions during pregnancy. This included 118 women (1.24/1000) who filled prescriptions for non-contraceptive oestrogens, 81 (0.85/1000) for sedatives, and 71 (0.75/1000) for statins. While many women had physician visits with a diagnosis consistent with a possible indication for an individual drug outside of pregnancy, none of these indications is included for use during pregnancy. Older women and disabled women were more likely than younger women (P < 0.0001) and women enrolled for other reasons (P < 0.0001) to fill category X prescriptions. Nearly two-thirds of the 391 women filled prescriptions after clinical signs or pregnancy tests would indicate pregnancy; nearly 40% filled a category X prescription after a pregnancy-related physician visit. Although the absolute rate of category X medication use in pregnancy is low, substantial numbers of women and their fetuses are exposed during pregnancy. Women above the age of 35 years and women enrolled in TennCare because of disabilities were more likely to fill prescriptions for category X medications during pregnancy than others, implying that risk communication to practitioners and women should focus on identification of these women to reduce their risk of exposure.
William O Cooper; Gerald B Hickson; Wayne A Ray
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  18     ISSN:  0269-5022     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-03     Completed Date:  2004-05-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  106-11     Citation Subset:  IM    
Division of General Pediatrics/Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-8555, USA.
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MeSH Terms
Clinical Competence / statistics & numerical data
Drug Prescriptions / statistics & numerical data*
Gestational Age
Managed Care Programs / statistics & numerical data
Medicaid / statistics & numerical data
Pharmaceutical Preparations / contraindications*
Prenatal Care / statistics & numerical data*
Prenatal Exposure Delayed Effects
Risk Factors
Grant Support
1U18HS10384-01/HS/AHRQ HHS; FDU-001646/FD/FDA HHS
Reg. No./Substance:
0/Pharmaceutical Preparations

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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