Drug prescription in pregnancy: analysis of a large statutory sickness fund population
Drug prescription in pregnancy: analysis of a large statutory sickness fund population
复制标题
DOI：
10.1007/s00228-004-0817-1
复制
发表时间：
2004-11-01
影响因子：
2.9
通讯作者：
Hasford, J
中科院分区：
文献类型：
--
作者：
Egen-Lappe, V;Hasford, J
目的：检查处方的药物在德国之前，期间和之后pregnancy.Methods：第一次，处方数据的一个大队列的孕妇，从德国法定疾病基金，可用于科学分析。对于2000年6月至2001年5月期间分娩的每名妇女，考虑了怀孕前两个时期（每个90天）的报销处方，分娩期间三个时期和分娩后两个时期。结果：在41.293名孕妇中，96.4%的孕妇在孕期至少接受过一种药物治疗。平均每名女性处方7种药物。不包括维生素、矿物质、碘化物和铁，85.2%的人至少接受过一种药物，中位数为3。镁是迄今为止最常见的处方物质（占所有处方的20%，占61%的妇女）。铁（54%的女性）和碘化物（31%）也经常被处方。妇科抗感染药的处方率（最高在妊娠晚期：23%的妇女），抗酸剂（最高在妊娠晚期：23%的妇女）。第三次修剪：11%）。以及止吐剂和抗恶心剂（max.在第一次修剪中：8%）在怀孕期间大幅增加。例如，止痛药、抗风湿药、肌肉松弛剂、眼科药物和抗痤疮制剂的销售量有所下降。潜在的致畸药物规定的1.3%的women.Conclusion：一个大的全国范围内的孕妇队列的分析表明，在怀孕期间的药物规定的大多数妇女，即使当维生素，矿物质，碘化物和铁被省略。镁和铁似乎被过度处方。另一方面，官方建议用碘替代以预防母亲和儿童的甲状腺疾病，但没有得到充分执行。我们认为，定期分析处方数据可以识别潜在的有害疗法和需要指南的焦点，并可以检查其实施情况。
Objective: To examine the prescription of drugs in Germany prior to, during and after pregnancy.Methods: For the first time, prescription data of a large cohort of pregnant women, from a German statutory sickness fund, were available for scientific analysis. For each woman who gave birth between June 2000 and May 2001 reimbursed prescriptions for two periods (90 days each) before pregnancy, three during and two after delivery were considered. The drugs were classified according to the ATC code.Results: Of the 41.293 women, 96.4% received at least one drug during pregnancy. A median of 7 drugs per women was prescribed. Excluding vitamins, minerals, iodide and iron, 85.2% received at least one drug and the median was 3. Magnesium, which was seldom prescribed outside of pregnancy, was by far the most frequently prescribed substance (20% of all prescriptions, 61% of the women). Iron (54% of the women) and iodide (31%) were also prescribed often. The prescription rates of gynaecological antiinfectives (maximum in third trimester: 23% of the women), antacids (max. in third trim.: 11%). as well as antiemetics and antinauseants (max. in first trim.: 8%) during pregnancy considerably increased. A decrease was seen for analgesics, antiinflammatory and antirheumatic drugs, muscle relaxants, ophtalmologicals and anti-acne preparations, for example. Potential teratogenic drugs were prescribed to 1.3% of the women.Conclusion: This analysis of a large nation-wide cohort of pregnant women showed that during pregnancy drugs were prescribed to most women, even when vitamins, minerals, iodide and iron were omitted. Magnesium and iron seemed to have been over-prescribed. On the other hand, the official recommendation for iodide substitution, to prevent thyroid diseases in mother and child, was insufficiently implemented. In our opinion, regular analysis of prescription data can identify potential harmful therapies and focal points where guidelines are needed and can check their implementation.