Evaluation of drug safety among pregnant women with antihypertensive drugs

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[Background] Pregnancy-induced hypertension (PIH) occurs in 5-10% of pregnant women, but information about antihypertensive drugs prescribed to patients with PIH is limited. [Objective] To clarify the prescription of antihypertensive drugs to pregnant women based on claims data. [Methods] We used health insurance claim (claims) data between January 1,2008 and May 31, 2010 at the Japan Medical Data Center. Pregnant women were detected by the information about health insurance claim (claims) data. Pregnancy duration for each woman was estimated by pregnancy week number, start date of medical care in claims for the mothers. Information on drug prescriptions during pregnancy was extracted from medical records or records of dispensed prescriptions. Prescription of antihypertensive drugs during pregnancy was evaluated among all pregnant women and pregnant women with a hypertension-related diagnosis (ICD-10 classification: O10-O16), respectively. [Results] We identified 19,282 pregnant women … More (mean age; 30.5±4.7 years, 15.6-49.4 years) from about 90 million health insurance claim (claims) data. Of these, 744 women (0.04%) had been prescribed an antihypertensive drug during pregnancy. The most frequently prescribed antihypertensive drugs during total pregnancy period, first trimester, second trimester, and third trimester were ‘Furosemide’(n=328), ‘Methyldopa’(n=13), ‘Methyldopa’(n=25), ‘Furosemide’(n=299) , respectively. Among 19,282 pregnant women, 1101 pregnant women were diagnosed as hypertension during pregnancy (ICD-10 classification: O10-O16). Of these, 161 women(14.6％) had been prescribed an antihypertensive drug during pregnancy. The most frequently prescribed antihypertensive drugs during total pregnancy period, first trimester, second trimester, and third trimester were ‘Nifedipine’(n=63),‘Hydralazine’ and ‘Methyldopa’(n=4, respectively), ‘Hydralazine’(n=9), ‘Nifedipine’(n=56), respectively. [Conclusion] We found that prescription of drugs among pregnant women should be evaluated regardless of the presence or absence of the diagnosis as hypertension during pregnancy when we examine the prescription of antihypertensive drugs to pregnant women based on claims data. Less