Document Detail


Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007: a medication exposure in pregnancy risk evaluation program study.
MedLine Citation:
PMID:  23061694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED use has increased among pregnant women in the US, 2001-2007.
METHODS:   We analysed data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 to 31 December 2007. We identified liveborn deliveries among women, aged 15-45 years on delivery date, who were members of MEPREP health plans (n=585615 deliveries). Pregnancy exposure to AEDs, determined through outpatient pharmacy dispensing files. Older AEDs were available for clinical use before 1993; other agents were considered newer AEDs. Information on sociodemographic and medical/reproductive factors was obtained from linked birth certificate files. Maternal diagnoses were identified based on ICD-9 codes.
RESULTS:   Prevalence of AED use during pregnancy increased between 2001 (15.7 per 1000 deliveries) and 2007 (21.9 per 1000 deliveries), driven primarily by a fivefold increase in the use of newer AEDs. Thirteen per cent of AED-exposed deliveries involved a combination of two or more AEDs. Psychiatric disorders were the most prevalent diagnoses, followed by epileptic and pain disorders, among AED users regardless of AED type, year of conception or gestational period.
CONCLUSIONS:   AED use during pregnancy increased between 2001 and 2007, driven by a fivefold increase in the use of newer AEDs. Nearly one in eight AED-exposed deliveries involved the concomitant use of more than one AED. Additional investigations of the reproductive safety of newer AEDs may be needed.
Authors:
William V Bobo; Robert L Davis; Sengwee Toh; De-Kun Li; Susan E Andrade; T Craig Cheetham; Pamala Pawloski; Sascha Dublin; Simone Pinheiro; Tarek Hammad; Pamela E Scott; Richard A Epstein; Patrick G Arbogast; James A Morrow; Judith A Dudley; Jean M Lawrence; Lyndsay A Avalos; William O Cooper
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  26     ISSN:  1365-3016     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-15     Completed Date:  2013-04-02     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  578-88     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Psychiatry, Vanderbilt University School of Medicine; Nashville, TN 37211, USA. william.v.bobo@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / therapeutic use*
Cohort Studies
Drug Prescriptions / statistics & numerical data*
Drug Utilization / trends*
Epilepsy / drug therapy*
Female
Humans
Middle Aged
Pregnancy
Prenatal Exposure Delayed Effects / epidemiology*
Program Evaluation
Risk
United States
Young Adult
Grant Support
ID/Acronym/Agency:
K23 AG028954/AG/NIA NIH HHS; K23 MH087747/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Anticonvulsants
Comments/Corrections

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


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