Palmsten Kristin, Hernández-Díaz Sonia, Chambers Christina D, Mogun Helen, Lai Sophia, Gilmer Todd P, Huybrechts Krista F
Departments of Pediatrics and Family Medicine and Public Health and the Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California; and the Department of Epidemiology, Harvard School of Public Health, the Division of Pharmacoepidemiology & Pharmacoeconomics, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Obstet Gynecol. 2015 Sep;126(3):465-473. doi: 10.1097/AOG.0000000000000982.
To characterize the 20 most common prescription medications and the 10 most common prescription medications classified in the former U.S. Food and Drug Administration categories D or X dispensed to pregnant women enrolled in the U.S. Medicaid program.
We conducted a cohort study of 1,106,757 pregnant women with live births using 2000-2007 Medicaid Analytic eXtract data. We used outpatient pharmacy records to identify medication dispensings and reported the proportion of pregnancies that were dispensed at least one prescription medication. Maternal age and race and ethnicity-stratified estimates were compared using prevalence ratios and 95% confidence intervals (CIs).
During pregnancy, 82.5% of the cohort had a dispensing for one or more prescription medication. The most commonly dispensed medications during pregnancy included nitrofurantoin (21.6%), metronidazole (19.4%), amoxicillin (18.0%), azithromycin (16.9%), and promethazine (13.5%). Proportions were highest among younger women for several medications; eg, nitrofurantoin (23.9% compared with 15.4%; prevalence ratio 1.55, CI 1.52-1.58), metronidazole (20.7% compared with 12.0%; prevalence ratio 1.73, CI 1.69-1.77), and azithromycin (21.1% compared with 11.0%; prevalence ratio 1.93, CI 1.89-1.97) were more common among women younger than 20 years than among women aged 35 years or older. Proportions were highest among white women with some exceptions; eg, compared with white women, metronidazole was more common among black women (29.8% compared with 14.4%; prevalence ratio 2.07, CI 2.05-2.09). Excluding fertility treatments, 42.0% had at least one dispensing for a D or X medication during pregnancy. Codeine (11.9%) and hydrocodone (10.2%) were the most common D medications.
Medications used to treat infections were the most commonly dispensed prescription medications. Dispensing of commonly used prescription medications during pregnancy varied by maternal age and race-ethnicity.
II.
对美国医疗补助计划中登记的孕妇所使用的20种最常见处方药以及按美国食品药品监督管理局（FDA）原D类或X类分类的10种最常见处方药进行特征描述。
我们利用2000 - 2007年医疗补助分析提取物数据，对1,106,757例有活产儿的孕妇进行了队列研究。我们使用门诊药房记录来识别药物配给情况，并报告至少配给一种处方药的妊娠比例。使用患病率比和95%置信区间（CI）比较了按孕产妇年龄、种族和民族分层的估计值。
孕期，该队列中82.5%的孕妇至少配给了一种处方药。孕期最常配给的药物包括呋喃妥因（21.6%）、甲硝唑（19.4%）、阿莫西林（1
