Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007: A medication exposure in pregnancy risk evaluation program study

William V. Bobo, Robert Davis, Sengwee Toh, De Kun Li, Susan E. Andrade, T. Craig Cheetham, Pamala Pawloski, Sascha Dublin, Simone Pinheiro, Tarek Hammad, Pamela E. Scott, Richard A. Epstein, Patrick G. Arbogast, James A. Morrow, Judith A. Dudley, Jean M. Lawrence, Lyndsay A. Avalos, William O. Cooper

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED use has increased among pregnant women in the US, 2001-2007. Methods: We analysed data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 to 31 December 2007. We identified liveborn deliveries among women, aged 15-45 years on delivery date, who were members of MEPREP health plans (n = 585 615 deliveries). Pregnancy exposure to AEDs, determined through outpatient pharmacy dispensing files. Older AEDs were available for clinical use before 1993; other agents were considered newer AEDs. Information on sociodemographic and medical/reproductive factors was obtained from linked birth certificate files. Maternal diagnoses were identified based on ICD-9 codes. Results: Prevalence of AED use during pregnancy increased between 2001 (15.7 per 1000 deliveries) and 2007 (21.9 per 1000 deliveries), driven primarily by a fivefold increase in the use of newer AEDs. Thirteen per cent of AED-exposed deliveries involved a combination of two or more AEDs. Psychiatric disorders were the most prevalent diagnoses, followed by epileptic and pain disorders, among AED users regardless of AED type, year of conception or gestational period. Conclusions: AED use during pregnancy increased between 2001 and 2007, driven by a fivefold increase in the use of newer AEDs. Nearly one in eight AED-exposed deliveries involved the concomitant use of more than one AED. Additional investigations of the reproductive safety of newer AEDs may be needed.

Original languageEnglish (US)
Pages (from-to)578-588
Number of pages11
JournalPaediatric and Perinatal Epidemiology
Volume26
Issue number6
DOIs
StatePublished - Nov 1 2012

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Anticonvulsants
Pregnant Women
Pregnancy
Program Evaluation
International Classification of Diseases
Birth Certificates
Somatoform Disorders
Drug Users
Psychiatry
Outpatients
Mothers
Databases
Safety
Health

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

Cite this

Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007 : A medication exposure in pregnancy risk evaluation program study. / Bobo, William V.; Davis, Robert; Toh, Sengwee; Li, De Kun; Andrade, Susan E.; Cheetham, T. Craig; Pawloski, Pamala; Dublin, Sascha; Pinheiro, Simone; Hammad, Tarek; Scott, Pamela E.; Epstein, Richard A.; Arbogast, Patrick G.; Morrow, James A.; Dudley, Judith A.; Lawrence, Jean M.; Avalos, Lyndsay A.; Cooper, William O.

In: Paediatric and Perinatal Epidemiology, Vol. 26, No. 6, 01.11.2012, p. 578-588.

Research output: Contribution to journalArticle

Bobo, WV, Davis, R, Toh, S, Li, DK, Andrade, SE, Cheetham, TC, Pawloski, P, Dublin, S, Pinheiro, S, Hammad, T, Scott, PE, Epstein, RA, Arbogast, PG, Morrow, JA, Dudley, JA, Lawrence, JM, Avalos, LA & Cooper, WO 2012, 'Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007: A medication exposure in pregnancy risk evaluation program study', Paediatric and Perinatal Epidemiology, vol. 26, no. 6, pp. 578-588. https://doi.org/10.1111/ppe.12004
Bobo, William V. ; Davis, Robert ; Toh, Sengwee ; Li, De Kun ; Andrade, Susan E. ; Cheetham, T. Craig ; Pawloski, Pamala ; Dublin, Sascha ; Pinheiro, Simone ; Hammad, Tarek ; Scott, Pamela E. ; Epstein, Richard A. ; Arbogast, Patrick G. ; Morrow, James A. ; Dudley, Judith A. ; Lawrence, Jean M. ; Avalos, Lyndsay A. ; Cooper, William O. / Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007 : A medication exposure in pregnancy risk evaluation program study. In: Paediatric and Perinatal Epidemiology. 2012 ; Vol. 26, No. 6. pp. 578-588.
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abstract = "Background: Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED use has increased among pregnant women in the US, 2001-2007. Methods: We analysed data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 to 31 December 2007. We identified liveborn deliveries among women, aged 15-45 years on delivery date, who were members of MEPREP health plans (n = 585 615 deliveries). Pregnancy exposure to AEDs, determined through outpatient pharmacy dispensing files. Older AEDs were available for clinical use before 1993; other agents were considered newer AEDs. Information on sociodemographic and medical/reproductive factors was obtained from linked birth certificate files. Maternal diagnoses were identified based on ICD-9 codes. Results: Prevalence of AED use during pregnancy increased between 2001 (15.7 per 1000 deliveries) and 2007 (21.9 per 1000 deliveries), driven primarily by a fivefold increase in the use of newer AEDs. Thirteen per cent of AED-exposed deliveries involved a combination of two or more AEDs. Psychiatric disorders were the most prevalent diagnoses, followed by epileptic and pain disorders, among AED users regardless of AED type, year of conception or gestational period. Conclusions: AED use during pregnancy increased between 2001 and 2007, driven by a fivefold increase in the use of newer AEDs. Nearly one in eight AED-exposed deliveries involved the concomitant use of more than one AED. Additional investigations of the reproductive safety of newer AEDs may be needed.",
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AU - Davis, Robert

AU - Toh, Sengwee

AU - Li, De Kun

AU - Andrade, Susan E.

AU - Cheetham, T. Craig

AU - Pawloski, Pamala

AU - Dublin, Sascha

AU - Pinheiro, Simone

AU - Hammad, Tarek

AU - Scott, Pamela E.

AU - Epstein, Richard A.

AU - Arbogast, Patrick G.

AU - Morrow, James A.

AU - Dudley, Judith A.

AU - Lawrence, Jean M.

AU - Avalos, Lyndsay A.

AU - Cooper, William O.

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N2 - Background: Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED use has increased among pregnant women in the US, 2001-2007. Methods: We analysed data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 to 31 December 2007. We identified liveborn deliveries among women, aged 15-45 years on delivery date, who were members of MEPREP health plans (n = 585 615 deliveries). Pregnancy exposure to AEDs, determined through outpatient pharmacy dispensing files. Older AEDs were available for clinical use before 1993; other agents were considered newer AEDs. Information on sociodemographic and medical/reproductive factors was obtained from linked birth certificate files. Maternal diagnoses were identified based on ICD-9 codes. Results: Prevalence of AED use during pregnancy increased between 2001 (15.7 per 1000 deliveries) and 2007 (21.9 per 1000 deliveries), driven primarily by a fivefold increase in the use of newer AEDs. Thirteen per cent of AED-exposed deliveries involved a combination of two or more AEDs. Psychiatric disorders were the most prevalent diagnoses, followed by epileptic and pain disorders, among AED users regardless of AED type, year of conception or gestational period. Conclusions: AED use during pregnancy increased between 2001 and 2007, driven by a fivefold increase in the use of newer AEDs. Nearly one in eight AED-exposed deliveries involved the concomitant use of more than one AED. Additional investigations of the reproductive safety of newer AEDs may be needed.

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