Trends and patterns of antiseizure medication prescribing during pregnancy between 1995 and 2018 in the United Kingdom: A cohort study.
Trends and patterns of antiseizure medication prescribing during pregnancy between 1995 and 2018 in the United Kingdom: A cohort study.
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1995 年至 2018 年英国怀孕期间抗癫痫药物处方的趋势和模式：一项队列研究。
DOI：
10.1111/1471-0528.17573
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Forbes,Harriet
中科院分区：
文献类型：
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作者：
Madley-Dowd,Paul;Rast,Jessica;Ahlqvist,ViktorH;Zhong,Caichen;Martin,FlorenceZ;Davies,NeilM;Lyall,Kristen;Newschaffer,Craig;Tomson,Torbjörn;Magnusson,Cecilia;Rai,Dheeraj;Lee,BrianK;Forbes,Harriet
目的检查孕期抗癫痫药物处方。设计基于人口的药物利用研究。设置英国1995年至2018年初级和二级保健数据，来自临床实践研究DATALINK GOLD版本。人口或样本752 112在登记至少12个 月的妇女中完成怀孕，在估计的怀孕开始前和她们的孕期内符合标准的一般做法。方法我们描述了整个研究期间的抗癫痫药物处方，总体上和根据ASM适应症，检查了妊娠期的处方模式，包括持续处方和停药，结果妊娠期ASM处方从1995年的0.6%增加到2018年的1.6%，主要是由于有癫痫以外的其他指征的妇女的增加所致。使用ASM处方的62.5%的孕妇有癫痫的指征，66.6%的孕妇有非癫痫的指征。妊娠期持续服用ASM在癫痫妇女中(64.3%)比其他适应症妇女(25.3%)更常见。切换ASM的频率很低(0.8%的ASM用户)。与停药相关的因素包括年龄≥35，较高的社会剥夺，与全科医生更频繁的接触，以及服用抗抑郁药或抗精神病药物。结论1995年至2018年，英国妊娠期ASM处方增加。关于妊娠期的处方模式因适应症而异，并与几个母亲的特征有关。
ObjectiveTo examine antiseizure medication (ASM) prescription during pregnancy.DesignPopulation‐based drug utilisation study.SettingUK primary and secondary care data, 1995–2018, from the Clinical Practice Research Datalink GOLD version.Population or Sample752 112 completed pregnancies among women registered for a minimum of 12 months with an ‘up to standard’ general practice prior to the estimated start of pregnancy and for the duration of their pregnancy.MethodsWe described ASM prescription across the study period, overall and by ASM indication, examined patterns of prescription during pregnancy including continuous prescription and discontinuation, and used logistic regression to investigate factors associated with those ASM prescription patterns.Main Outcome MeasuresPrescription of ASMs during pregnancy and discontinuation of ASMs before and during pregnancy.ResultsASM prescription during pregnancy increased from 0.6% of pregnancies in 1995 to 1.6% in 2018, driven largely by an increase in women with indications other than epilepsy. Epilepsy was an indication for 62.5% of pregnancies with an ASM prescription and non‐epilepsy indications were present for 66.6%. Continuous prescription of ASMs during pregnancy was more common in women with epilepsy (64.3%) than in women with other indications (25.3%). Switching ASMs was infrequent (0.8% of ASM users). Factors associated with discontinuation included age ≥35, higher social deprivation, more frequent contact with the GP and being prescribed antidepressants or antipsychotics.ConclusionsASM prescription during pregnancy increased between 1995 and 2018 in the UK. Patterns of prescription around the pregnancy period vary by indication and are associated with several maternal characteristics.