Monitoring medicine prescriptions before, during and after pregnancy in Italy.

Filomena Fortinguerra, Valeria Belleudi, Francesca Romana Poggi, Serena Perna, Renata Bortolus, Serena Donati, Paola D'Aloja, Roberto Da Cas, Antonio Clavenna, Anna Locatelli, Antonio Addis, Marina Davoli, Francesco Trotta

Journal: PloS one 2023;18(6):e0287111

PMID: 37319236

Abstract

BACKGROUND

The use of medications during pregnancy is a common event worldwide. Monitoring medicine prescriptions in clinical practice is a necessary step in assessing the impact of therapeutic choices in pregnant women as well as the adherence to clinical guidelines. The aim of this study was to provide prevalence data on medication use before, during and after pregnancy in the Italian population.

METHODS

A retrospective prevalence study using administrative healthcare databases was conducted. A cohort of 449,012 pregnant women (15-49 years) residing in eight Italian regions (59% of national population), who delivered in 2016-2018, were enrolled. The prevalence of medication use was estimated as the proportion (%) of pregnant women with any prescription.

RESULTS

About 73.1% of enrolled women received at least one drug prescription during pregnancy, 57.1% in pre-pregnancy and 59.3% in postpartum period. The prevalence of drug prescriptions increased with maternal age, especially during the 1st trimester of pregnancy. The most prescribed medicine was folic acid (34.6%), followed by progesterone (19%), both concentrated in 1st trimester of pregnancy (29.2% and 14.8%, respectively). Eight of the top 30 most prescribed medications were antibiotics, whose prevalence was higher during 2nd trimester of pregnancy in women ≥ 40 years (21.6%). An increase in prescriptions of anti-hypertensives, antidiabetics, thyroid hormone and heparin preparations was observed during pregnancy; on the contrary, a decrease was found for chronic therapies, such as anti-epileptics or lipid-modifying agents.

CONCLUSIONS

This study represents the largest and most representative population-based study illustrating the medication prescription patterns before, during and after pregnancy in Italy. The observed prescriptive trends were comparable to those reported in other European countries. Given the limited information on medication use in Italian pregnant women, the performed analyses provide an updated overview of drug prescribing in this population, which can help to identify critical aspects in clinical practice and to improve the medical care of pregnant and childbearing women in Italy.

Copyright: © 2023 Fortinguerra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Address: Italian Medicines Agency (AIFA), Rome, Italy.; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.; Directorate General for Preventive Health-Office 9, Ministry of Health, Rome, Italy.; National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità -Italian National Institute of Health, Rome, Italy.; Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità -Italian National Institute of Health, Rome, Italy.; Laboratory for Pharmacoepidemiology, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.; Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy.
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