Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Pharmacoepidemiol Drug Saf. 2011 Sep;20(9):895-902. doi: 10.1002/pds.2184. Epub 2011 Jul 20.
To review the literature describing patterns of outpatient prescription drug use during pregnancy by therapeutic category, potential for fetal harm, and overall.
We conducted a systematic review of peer-reviewed literature published from 1989 to 2010. We included studies evaluating individual-level exposures to prescription medicines during pregnancy. We selected only studies conducted in developed (Organization of Economic Co-operation and Development) countries and published in English.
Published drug utilization studies reveal wide variation in estimates of overall prescription drug use in pregnancy (27-93% of pregnant women filling at least one prescription excluding vitamins and minerals). Among studies of similar design, estimates were lowest in Northern European countries (44-47%) and highest in France (93%) and Germany (85%). Measured rates of use of contraindicated medicines in pregnancy ranged from 0.9% (Denmark, 1991-1996) to 4.6% (USA, 1996-2000). The use of medicines with positive evidence of risk ranged from 2.0% (Italy, 2004) to 59.3% (France, 1996).
Avoidable inconsistencies in study design and reporting attenuate conclusions that can be drawn from the literature on antenatal drug utilization. Nevertheless, the body of published research shows that antenatal prescription drug use is common, with many studies finding that a majority of women use one or more prescription medicine during pregnancy. Similarly, studies consistently report the use of drugs recognized as having potential risks in pregnancy. Given this widespread use, it is particularly important to develop standards for calculating and reporting antenatal exposures to improve the value of future research in this area.
综述描述按治疗类别、对胎儿潜在危害以及总体情况划分的孕妇门诊处方药使用模式的文献。
我们对 1989 年至 2010 年期间发表的同行评议文献进行了系统性综述。我们纳入了评估孕妇个体接触处方药情况的研究。我们只选择在发达国家（经济合作与发展组织）进行且以英文发表的研究。
已发表的药物利用研究表明，孕妇总体处方药使用的估计值差异很大（27-93%的孕妇至少开了一种处方药，不包括维生素和矿物质）。在设计相似的研究中，北欧国家（44-47%）的估计值最低，法国（93%）和德国（85%）的估计值最高。在妊娠期间禁忌药物的使用率从 0.9%（丹麦，1991-1996 年）到 4.6%（美国，1996-2000 年）不等。具有阳性风险证据的药物的使用率从 2.0%（意大利，2004 年）到 59.3%（法国，1996 年）不等。
研究设计和报告中的可避免差异削弱了从产前药物利用文献中得出的结论。然而，已发表研究的总体情况表明，产前处方药的使用很常见，许多研究发现大多数女性在怀孕期间使用一种或多种处方药。同样，研究一致报告了使用被认为在怀孕期间具有潜在风险的药物。鉴于这种广泛的使用，制定计算和报告产前暴露的标准尤为重要，以提高该领域未来研究的价值。
