Examination of the prescription of antiepileptic drugs to prenatal and postpartum women in Japan from a health administrative database
Examination of the prescription of antiepileptic drugs to prenatal and postpartum women in Japan from a health administrative database
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DOI：
10.1002/pds.4749
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发表时间：
2019-06-01
影响因子：
2.6
通讯作者：
Mano, Nariyasu
中科院分区：
文献类型：
--
作者：
Ishikawa, Tomofumi;Obara, Taku;Mano, Nariyasu
目的利用大型管理数据库评估日本产前和产后妇女抗癫痫药物（AED）处方的流行率和模式。方法使用已发表的算法和婴儿出生月份估计妊娠开始和分娩日期。在妊娠发作前180天、妊娠期间和产后180天，对处方AED的患病率、某些AED的最大剂量和可能的AED联合治疗频率进行了评价。结果33941例孕妇符合分析条件。在怀孕前180天和产后180天之间，225名妇女（每10000次分娩中有66名）和135名妇女（每10000次分娩中有40名）在怀孕期间至少服用了一种AED。AED处方的流行率在前三个月和中三个月下降，在后三个月和产后增加。丙戊酸盐是最常处方的药物，其次是氯硝西泮、拉莫三嗪和卡马西平。在妊娠早期至少有一次丙戊酸盐处方记录的49例女性中，9例（18.4%）的丙戊酸盐处方剂量超过600 mg/天。关于潜在的联合治疗，40例（12/10000分娩）分别在妊娠前180天至产后180天期间同时接受两种或多种AED，31例（9/10000分娩）妇女在妊娠期间接受这些药物。结论日本孕妇使用各种抗癫痫药物。育龄妇女应在怀孕前根据风险受益情况选择合适的AED。
Purpose To evaluate the prevalence and patterns of prescriptions of antiepileptic drugs (AEDs) to prenatal and postpartum women in Japan using a large administrative database. Methods The dates of pregnancy onset and delivery were estimated using published algorithms and infant birth months. The prevalence of prescribed AEDs, the maximum dose of some AEDs, and the frequency of potential combination therapy with AEDs were evaluated for the 180 days before pregnancy onset, during pregnancy, and at 180-day postpartum. Results In total, 33 941 pregnant women were eligible for analysis. At least one AED was prescribed to 225 women (66 per 10 000 deliveries) between 180 days before pregnancy and 180-day postpartum and for 135 women (40 per 10 000 deliveries) during pregnancy. The prevalence of AED prescription declined during the first and second trimesters and increased in the third trimester and postpartum. Valproate was the most frequently prescribed drug, followed by clonazepam, lamotrigine, and carbamazepine. Nine (18.4%) of the 49 women with at least one prescription record of valproate in the first trimester were prescribed more than 600 mg/day of valproate. Concerning potential combination therapy, 40 (12 per 10 000 deliveries) concurrently received two or more AEDs between 180 days before pregnancy and 180-day postpartum, respectively, 31 (9 per 10 000 deliveries) women received these drugs during pregnancy. Conclusions Various AEDs were prescribed to pregnant Japanese women. Women of reproductive age should select the appropriate AED before becoming pregnant, depending on the risk benefit profile.