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- Lupattelli, A., et al.
(author)
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Medication use in pregnancy: a cross-sectional, multinational web-based study
- 2014
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In: BMJ Open. - : BMJ. - 2044-6055. ; 4:2
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Journal article (peer-reviewed)abstract
- Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.
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- Bjelland, E. K., et al.
(author)
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Hormonal contraception and pelvic girdle pain during pregnancy : a population study of 91 721 pregnancies in the Norwegian Mother and Child Cohort
- 2013
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In: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 28:11, s. 3134-3140
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Journal article (peer-reviewed)abstract
- Is pre-pregnancy hormonal contraception use associated with the development of pelvic girdle pain during pregnancy? In contrast to combined oral contraceptive pills, long lifetime exposure to progestin-only contraceptive pills or the use of a progestin intrauterine device during the final year before pregnancy were associated with pelvic girdle pain. Pelvic girdle pain severely affects many women during pregnancy. Smaller studies have suggested that hormonal contraceptive use is involved in the underlying mechanisms, but evidence is inconclusive. A population study during the years 19992008. A total of 91 721 pregnancies included in the Norwegian Mother and Child Cohort Study. Data were obtained by two self-administered questionnaires during pregnancy weeks 17 and 30. Pelvic girdle pain was present in 12.9 of women who had used combined oral contraceptive pills during the last pre-pregnancy year, 16.4 of women who had used progestin-only contraceptive pills, 16.7 of women who had progestin injections and 20.7 of women who had used progestin intrauterine devices, compared with 15.3 of women who did not report use of hormonal contraceptives. After adjustment for other study factors, the use of a progestin intrauterine device was the only factor based on the preceding year associated with pelvic girdle pain [adjusted odds ratios (OR) 1.20; 95 confidence interval (CI): 1.111.31]. Long lifetime exposure to progestin-only contraceptive pills was also associated with pelvic girdle pain (adjusted OR 1.49; 95 CI: 1.012.20). The participation rate was 38.5. However, a recent study on the potential biases of skewed selection in the Norwegian Mother and Child Cohort Study found the prevalence estimates but not the exposure-outcome associations to be influenced by the selection. The results suggest that combined oral contraceptives can be used without fear of developing pelvic girdle pain during pregnancy. However, the influence of progestin intrauterine devices and long-term exposure to progestin-only contraceptive pills requires further study. The present study was supported by the Norwegian Research Council. None of the authors has a conflict of interest.
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- Mårdby, Ann-Charlotte, 1976, et al.
(author)
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Consumption of alcohol during pregnancy-A multinational European study
- 2017
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In: Women and Birth. - : Elsevier BV. - 1871-5192. ; 30:4
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Journal article (peer-reviewed)abstract
- Background: Although single-country studies indicate alcohol consumption among some pregnant European women, it is difficult to interpret European differences. Few multinational studies exist using the same methodology. Aim: To estimate the proportion of women consuming alcohol during pregnancy in Europe, and to analyze whether between country variations could be explained by sociodemography and smoking. Methods: An anonymous online questionnaire was accessible for pregnant women and new mothers in 11 European countries during two months between October 2011 and February 2012 in each country. The questionnaire covered alcohol consumption, sociodemographic factors, and smoking habits during pregnancy. Descriptive analyses and logistic regression models were conducted. Findings: The study population consisted of 7905 women, 53.1% pregnant and 46.9% new mothers. On average, 15.8% reported alcohol consumption during pregnancy. The highest proportion of alcohol consumption during pregnancy was found in the UK (28.5%), Russia (26.5%), and Switzerland (20.9%) and the lowest in Norway (4.1%), Sweden (7.2%), and Poland (9.7%). When reporting alcohol consumption during pregnancy, 39% consumed at least one unit per month. In Italy, Switzerland, and the UK, over half consumed at least one alcohol unit per month. Higher education and smoking before pregnancy were predictors of alcohol consumption during pregnancy. Conclusions: Almost 16% of women resident in Europe consumed alcohol during pregnancy with large cross-country variations. Education and smoking prior to pregnancy could not fully explain the differences between the European countries. A united European strategy to prevent alcohol consumption during pregnancy is needed with focus on countries with the highest consumption. (C) 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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- Noh, Y, et al.
(author)
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Prenatal and Infant Exposure to Acid-Suppressive Medications and Risk of Allergic Diseases in Children
- 2023
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In: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6211 .- 2168-6203. ; 177:3, s. 267-277
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Journal article (peer-reviewed)abstract
- Existing observational data have indicated positive associations of acid-suppressive medication (ASM) use in prenatal and early life with allergic diseases in children; however, no study to date has accounted for confounding by indication or within-familial factors.ObjectiveTo evaluate the association of prenatal or infant exposure to ASMs with risk of allergic diseases in children.Design, Setting, and ParticipantsThis nationwide, cohort study included data from South Korea’s National Health Insurance Service mother-child–linked database from January 1, 2007, to December 31, 2020. Participants included mother-child pairs of neonates born from April 1, 2008, to December 31, 2019.ExposuresPrenatal and infant exposure to ASMs (histamine 2 receptor antagonists [H2RAs] and proton pump inhibitors [PPIs]).Main Outcomes and MeasuresComposite and individual outcomes of allergic diseases (asthma, allergic rhinitis, atopic dermatitis, and food allergy) in children (followed up to 13 years of age) were assessed. The ASM-exposed individuals were compared with unexposed individuals in propensity score (PS)–matched and sibling-matched analyses to control for various potential confounders and within-familial factors. Hazard ratios (HRs) with 95% CIs were estimated using Cox proportional hazards regression models.ResultsThe study included 4 149 257 mother-child pairs. Prenatal exposure analyses included 808 067 PS-matched pairs (763 755 received H2RAs, 36 529 received PPIs) among women with a mean (SD) age of 31.8 (4.2) years. The PS-matched HR was 1.01 (95% CI, 1.01-1.02) for allergic diseases overall (asthma: HR, 1.02 [95% CI, 1.01-1.03]; allergic rhinitis: HR, 1.02 [95% CI, 1.01-1.02]; atopic dermatitis: HR, 1.02 [95% CI, 1.01-1.02]; food allergy: HR, 1.03 [95% CI, 0.98-1.07]); in sibling-matched analyses, the HRs were similar to those of PS-matched analyses but were not significant (allergic diseases: HR, 1.01; 95% CI, 0.997-1.01). Infant exposure analyses included 84 263 PS-matched pairs (74 188 received H2RAs, 7496 received PPIs). The PS-matched HR was 1.06 (95% CI, 1.05-1.07) for allergic diseases overall (asthma: HR, 1.16 [95% CI, 1.14-1.18]; allergic rhinitis: HR, 1.02 [95% CI, 1.01-1.03]; atopic dermatitis: HR, 1.05 [95% CI, 1.02-1.08]; food allergy: HR, 1.28 [95% CI, 1.10-1.49]); asthma risk (HR, 1.13; 95% CI, 1.09-1.17) remained significantly higher among children exposed to ASMs during infancy in sibling-matched analyses. The findings were similar for H2RAs and PPIs analyzed separately and were robust across all sensitivity analyses.Conclusions and RelevanceThe findings of this cohort study suggest that there is no association between prenatal exposure to ASMs and allergic diseases in offspring. However, infant exposure to ASMs was associated with a higher risk of developing asthma, although the magnitude was more modest than previously reported. Clinicians should carefully weigh the benefits of prescribing ASMs to children, accompanied by subsequent close monitoring for any clinically relevant safety signals.
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