Engeland Anders, Bjørge Tone, Klungsøyr Kari, Hjellvik Vidar, Skurtveit Svetlana, Furu Kari
Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Pharmacoepidemiol Drug Saf. 2018 Sep;27(9):995-1004. doi: 10.1002/pds.4577. Epub 2018 Jun 19.
To explore trends in use of maternal medication 3 months prior to, during and 3 months after pregnancy.
Data on births from the Medical Birth Registry of Norway were linked to the Norwegian Prescription Database, identifying women's use of medications around pregnancy. All women giving birth in Norway during 2005 to 2015 (638 532 singleton births to 414 567 women) were included. Proportions of pregnant women using different medications in association with pregnancy, and annual relative change in medication use during 2005 to 2015, were calculated.
In Norway, 60% of pregnant women used prescription medications during pregnancy (2005-15), increasing from 57% in 2005 to 62% in 2015. The annual relative increase was 0.9% (95% CI: 0.8-1.0). In the first trimester, approximately 17% of the women used medications regarded as potentially teratogenic during 2005 to 2015, increasing from 15% to 19%. Overall, this proportion was higher in the first than in the second (8.9%) and third (8.0%) trimesters, and higher than in the 3 months after pregnancy (14%). The annual relative increase of medications regarded as potentially teratogenic in the first trimester was 2.5% (95% CI: 2.3-2.7).
The proportion of women using potentially teratogenic medications in the first trimester of pregnancy have increased during the last decade. Clinicians need to be aware of the possibility of pregnancy when prescribing potentially teratogenic medication to women of fertile age and focus this in the consultations. The increasing trends call for the need of routine surveillance of adverse birth outcomes linked to medication use in pregnancy.
探讨孕期前3个月、孕期及产后3个月孕产妇用药的趋势。
挪威医疗出生登记处的出生数据与挪威处方数据库相链接，以确定女性在孕期前后的用药情况。纳入了2005年至2015年在挪威分娩的所有女性（414567名女性的638532例单胎分娩）。计算了孕期使用不同药物的孕妇比例，以及2005年至2015年期间药物使用的年度相对变化。
在挪威，60%的孕妇在孕期（2005 - 2015年）使用处方药，从2005年的57%增至2015年的62%。年度相对增长率为0.9%（95%置信区间：0.8 - 1.0）。在孕早期，2005年至2015年期间约17%的女性使用了被视为潜在致畸的药物，从15%增至19%。总体而言，这一比例在孕早期高于孕中期（8.9%）和孕晚期（8.0%），且高于产后3个月（14%）。孕早期被视为潜在致畸药物的年度相对增长率为2.5%（95%置信区间：2.3 - 2.7）。
在过去十年中，孕早期使用潜在致畸药物的女性比例有所增加。临床医生在为育龄期女性开具潜在致畸药物处方时需要意识到怀孕的可能性，并在会诊中予以关注。这种增长趋势要求对与孕期用药相关的不良出生结局进行常规监测。
