Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland.
Int J Environ Res Public Health. 2022 Jan 27;19(3):1456. doi: 10.3390/ijerph19031456.
Evidence on the use of drugs during pregnancy in Switzerland is lacking. We aimed to evaluate the utilisation of drugs to treat chronic diseases during pregnancy in Switzerland. We identified all pregnancies (excluding abortions) in Swiss Helsana claims data (2014-2018). In those, we identified all claims for drugs to treat a chronic disease, which typically affects women of childbearing age. Potentially teratogenic/fetotoxic drugs were evaluated during specific risk periods. Results were demographically weighted relative to the Swiss population. We identified claims for ≥1 drug of interest during 22% of 369,371 weighted pregnancies. Levothyroxine was most frequently claimed (6.6%). Antihypertensives were claimed during 5.3% (3.9% nifedipine in T3). Renin-Angiotensin-Aldosterone System (RAAS) inhibitors were dispensed to 0.3/10,000 pregnancies during trimester 2 (T2) or trimester 3 (T3). Insulin was claimed during 3.5% of pregnancies, most frequently in T3 (3.3%). Exposure to psychotropic drugs was 3.8% (mostly Selective serotonin reuptake inhibitors (SSRIs)) and to drugs for obstructive airway diseases 3.6%. Traditional immunosuppressants (excluding corticosteroids) were claimed during 0.5% (mainly azathioprine and hydroxychloroquine), biologic immunosuppressants (Tumour necrosis factor-alpha (TNF-alpha) inhibitors and interleukin inhibitors) during 0.2%, and drugs to treat multiple sclerosis during 0.09% of pregnancies. Antiretrovirals were claimed during 0.15% of pregnancies. Patterns of drug claims were in line with treatment recommendations, but relatively rare events of in utero exposure to teratogenic drugs may have had severe implications for those involved.
瑞士缺乏关于孕期用药的证据。我们旨在评估瑞士孕期治疗慢性疾病的药物使用情况。我们从瑞士 Helsana 理赔数据（2014-2018 年）中确定了所有妊娠（不包括流产）。在这些妊娠中，我们确定了所有用于治疗慢性疾病的药物理赔，这些疾病通常影响育龄妇女。在特定风险期评估潜在的致畸/胚胎毒性药物。结果根据瑞士人口进行了人口统计学加权。我们确定了 369371 个加权妊娠中，有 22%的妊娠至少使用了 1 种感兴趣的药物。左甲状腺素的使用率最高（6.6%）。降压药的使用率为 5.3%（T3 期硝苯地平占 3.9%）。肾素-血管紧张素-醛固酮系统（RAAS）抑制剂在 T2 期或 T3 期每 10000 例妊娠中分别有 0.3 例（3.5%）。胰岛素的使用率为 3.5%，在 T3 期（3.3%）最常见。精神药物的使用率为 3.8%（主要是选择性 5-羟色胺再摄取抑制剂（SSRIs）），阻塞性气道疾病药物的使用率为 3.6%。传统免疫抑制剂（不包括皮质类固醇）的使用率为 0.5%（主要是硫唑嘌呤和羟氯喹），生物免疫抑制剂（肿瘤坏死因子-α（TNF-α）抑制剂和白细胞介素抑制剂）的使用率为 0.2%，治疗多发性硬化症的药物的使用率为 0.09%。抗逆转录病毒药物的使用率为 0.15%。药物理赔模式符合治疗建议，但在宫内暴露于致畸药物的相对罕见事件可能对相关人员产生严重影响。
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