Locatelli Anna, Bellante Nicolò, Donatiello Gianluca, Fortinguerra Filomena, Belleudi Valeria, Poggi Francesca R, Perna Serena, Trotta Francesco
School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Italian Medicines Agency (AIFA), Rome, Italy.
Front Pharmacol. 2024 Aug 30;15:1370797. doi: 10.3389/fphar.2024.1370797. eCollection 2024.
Drug use during pregnancy should be evidence-based and favor the safest and most appropriate prescription. The Italian Medicines Agency (AIFA) coordinates a network focusing on monitoring medication use in pregnancy. Hypertensive disorders are common medical complication of pregnancy and antihypertensive therapy is prescribed to reduce the risk of adverse feto-maternal complications. The objective of this study is to highlight the prescription pattern of antihypertensive drugs before pregnancy, during pregnancy and in the postpartum period in Italy and to evaluate their use with a specific attention to the prescription pattern of drugs considered safe during pregnancy. A multi-database cross-sectional population study using a Common Data Model (CDM) was performed. We selected all women aged 15-49 years living in eight Italian regions who gave birth in hospital between 1 April 2016 and 31 March 2018. In a cohort of 449.012 women, corresponding to 59% of Italian deliveries occurred in the study period, the prevalence of prescription of antihypertensive drugs in the pre-conceptional period was 1.2%, in pregnancy 2.0% and in the postpartum period 2.9%. Beta-blockers were the most prescribed drugs before pregnancy (0.28%-0.30%). Calcium channel blockers were the most prescribed drugs during pregnancy, with a prevalence of 0.23%, 0.33%, 0.75% in each trimester. Alfa-2-adrenergic receptor agonists were the second most prescribed during pregnancy with a prevalence of 0.16%, 0.26% and 0.55% in each trimester. The prescription of drugs contraindicated during pregnancy was below 0.5%. Only a small percentage of women switched from a contraindicated drug to a drug compatible with pregnancy. The analysis showed little variability between the different Italian regions. In general, the prescription of antihypertensive drugs in the Italian Mom-Network is coherent with the drugs compatible with pregnancy.
孕期用药应以证据为基础，优先选择最安全、最合适的处方。意大利药品管理局（AIFA）协调一个专注于监测孕期用药的网络。高血压疾病是常见的孕期医学并发症，会开具抗高血压治疗药物以降低母婴不良并发症的风险。本研究的目的是突出意大利孕前、孕期及产后抗高血压药物的处方模式，并特别关注孕期被认为安全的药物的处方模式，对其使用情况进行评估。采用通用数据模型（CDM）进行了一项多数据库横断面人群研究。我们选取了2016年4月1日至2018年3月31日期间在意大利八个地区住院分娩的所有15至49岁女性。在449012名女性队列中，占研究期间意大利分娩总数的59%，孕前抗高血压药物的处方率为1.2%，孕期为2.0%，产后为2.9%。β受体阻滞剂是孕前最常开具的药物（0.28%-0.30%）。钙通道阻滞剂是孕期最常开具的药物，在孕早期、孕中期和孕晚期的患病率分别为0.23%、0.33%、0.75%。α-2肾上腺素能受体激动剂是孕期第二常开具的药物，在孕早期、孕中期和孕晚期的患病率分别为0.16%、0.26%和0.55%。孕期禁忌药物的处方率低于0.5%。只有一小部分女性从禁忌药物转换为孕期适用药物。分析显示意大利不同地区之间差异不大。总体而言，意大利妈妈网络中抗高血压药物的处方与孕期适用药物一致。
