Trends and Determinants of Prescription Drug Use during Pregnancy and Postpartum in British Columbia, 2002-2011: A Population-Based Cohort Study

Kate Smolina, Gillian E Hanley, Barbara Mintzes, Tim F Oberlander, Steve Morgan, Kate Smolina, Gillian E Hanley, Barbara Mintzes, Tim F Oberlander, Steve Morgan

Abstract

Purpose: To describe trends, patterns, and determinants of prescription drug use during pregnancy and postpartum.

Methods: This is a retrospective, population-based study of all women who gave birth between January 2002 and 31 December 2011 in British Columbia, Canada. Study population consisted of 225,973 women who had 322,219 pregnancies. We examined administrative datasets containing person-specific information on filled prescriptions, hospitalizations, and medical services. Main outcome measures were filled prescriptions during pregnancy and postpartum. We used logistic regressions to examine associations between prescription drug use and maternal characteristics.

Results: Approximately two thirds of women filled a prescription during pregnancy, increasing from 60% in 2002 to 66% in 2011. The proportion of pregnant women using medicines in all three trimesters of pregnancy increased from 20% in 2002 to 27% in 2011. Use of four or more different types of prescription drug during at least one trimester increased from 8.4% in 2002 to 11.7% in 2011. Higher BMI, smoking during pregnancy, age under 25, carrying multiples, and being diagnosed with a chronic condition all significantly increased the odds of prescription drug use during pregnancy.

Conclusions: The observed increase in the number of prescriptions and number of different drugs being dispensed suggests a trend in prescribing practices with potentially important implications for mothers, their neonates, and caregivers. Monitoring of prescribing practices and further research into the safety of most commonly prescribed medications is crucial in better understanding risks and benefits to the fetus and the mother.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Overall patterns of prescription drug…
Fig 1. Overall patterns of prescription drug dispensations during pregnancy.
Fig 2. Trimesters during which prescriptions were…
Fig 2. Trimesters during which prescriptions were dispensed to women during pregnancies involving at least one prescription dispensation (number of pregnancies).
Fig 3. Pregnancies involving dispensation for four…
Fig 3. Pregnancies involving dispensation for four or more different drug types, by time period and year (excluding vitamins and minerals).
Fig 4. Patterns of prescription drug dispensations…
Fig 4. Patterns of prescription drug dispensations for most common drug classes by pregnancy-related period.
Fig 5. Trends in prescription drug dispensations…
Fig 5. Trends in prescription drug dispensations during pregnancy, most common drugs, 2002–11.

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