Journal article 91 views 9 downloads
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019
Anuradhaa Subramanian
,
Amaya Azcoaga-Lorenzo
,
Astha Anand
,
Katherine Phillips
,
Siang Ing Lee
,
Neil Cockburn
,
Adeniyi Francis Fagbamigbe
,
Christine Damase-Michel
,
Christopher Yau
,
Colin McCowan
,
Dermot O’Reilly
,
Gillian Santorelli
,
Holly Hope
,
Jonathan I. Kennedy
,
Kathryn M. Abel
,
Kelly-Ann Eastwood
,
Louise Locock
,
Mairead Black
,
Maria Loane
,
Ngawai Moss
,
Rachel Plachcinski
,
Shakila Thangaratinam
,
Sinead Brophy
,
Utkarsh Agrawal
,
Zoe Vowles
,
Peter Brocklehurst
,
Helen Dolk
,
Catherine Nelson-Piercy
,
Krishnarajah Nirantharakumar
,
(on behalf of the MuM-PreDiCT Group)
BMC Medicine, Volume: 21, Issue: 1
Swansea University Author:
Sinead Brophy
-
PDF | Version of Record
This article is licensed under a Creative Commons Attribution 4.0 International License.
Download (1.31MB)
DOI (Published version): 10.1186/s12916-022-02722-5
Abstract
BackgroundThe number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women an...
Published in: | BMC Medicine |
---|---|
ISSN: | 1741-7015 |
Published: |
Springer Science and Business Media LLC
2023
|
Online Access: |
Check full text
|
URI: | https://cronfa.swan.ac.uk/Record/cronfa66424 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
first_indexed |
2024-05-15T07:44:58Z |
---|---|
last_indexed |
2024-05-15T07:44:58Z |
id |
cronfa66424 |
recordtype |
SURis |
fullrecord |
<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66424</id><entry>2024-05-15</entry><title>Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019</title><swanseaauthors><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-05-15</date><deptcode>MEDS</deptcode><abstract>BackgroundThe number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy.MethodsA retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register.Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period.Logistic regression models were performed to identify risk factors for polypharmacy.ResultsDuring the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%.Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs).Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14–1.18) and 1.55 (1.53–1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33–2.47), 1.71 (1.65–1.76), 1.41 (1.35–1.47) and 1.39 (1.30–1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18–1.20) and 1.05 (1.03–1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy.ConclusionsThe prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus.</abstract><type>Journal Article</type><journal>BMC Medicine</journal><volume>21</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1741-7015</issnElectronic><keywords>Multiple medications, Polypharmacy, Medications, Prescriptions, Pregnancy, Multimorbidity, Multiple longterm conditions</keywords><publishedDay>16</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-01-16</publishedDate><doi>10.1186/s12916-022-02722-5</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was funded by the Strategic Priority Fund “Tackling multimorbidity at scale” programme [grant number MR/W014432/1] delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council. BT was funded by the National Institute for Health Research (NIHR) West Midlands Applied Research Collaboration. AA, KP and SIL were funded as NIHR Academic Clinical Fellows. The views expressed are those of the authors and not necessarily those of the funders, the NIHR or the UK Department of Health and Social Care. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.</funders><projectreference/><lastEdited>2024-06-19T15:52:47.0667175</lastEdited><Created>2024-05-15T08:41:26.7533659</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Anuradhaa</firstname><surname>Subramanian</surname><orcid>0000-0001-8875-7363</orcid><order>1</order></author><author><firstname>Amaya</firstname><surname>Azcoaga-Lorenzo</surname><orcid>0000-0003-3307-878x</orcid><order>2</order></author><author><firstname>Astha</firstname><surname>Anand</surname><orcid>0000-0003-0494-321x</orcid><order>3</order></author><author><firstname>Katherine</firstname><surname>Phillips</surname><orcid>0000-0003-0674-605x</orcid><order>4</order></author><author><firstname>Siang Ing</firstname><surname>Lee</surname><orcid>0000-0002-2332-5452</orcid><order>5</order></author><author><firstname>Neil</firstname><surname>Cockburn</surname><orcid>0000-0001-9284-6991</orcid><order>6</order></author><author><firstname>Adeniyi Francis</firstname><surname>Fagbamigbe</surname><orcid>0000-0001-9184-8258</orcid><order>7</order></author><author><firstname>Christine</firstname><surname>Damase-Michel</surname><orcid>0000-0001-5018-0108</orcid><order>8</order></author><author><firstname>Christopher</firstname><surname>Yau</surname><orcid>0000-0001-7615-8523</orcid><order>9</order></author><author><firstname>Colin</firstname><surname>McCowan</surname><orcid>0000-0002-9466-833x</orcid><order>10</order></author><author><firstname>Dermot</firstname><surname>O’Reilly</surname><orcid>0000-0002-9181-0652</orcid><order>11</order></author><author><firstname>Gillian</firstname><surname>Santorelli</surname><orcid>0000-0003-0427-1783</orcid><order>12</order></author><author><firstname>Holly</firstname><surname>Hope</surname><orcid>0000-0002-4834-6719</orcid><order>13</order></author><author><firstname>Jonathan I.</firstname><surname>Kennedy</surname><orcid>0000-0002-1122-6502</orcid><order>14</order></author><author><firstname>Kathryn M.</firstname><surname>Abel</surname><orcid>0000-0003-3538-8896</orcid><order>15</order></author><author><firstname>Kelly-Ann</firstname><surname>Eastwood</surname><orcid>0000-0003-3689-0490</orcid><order>16</order></author><author><firstname>Louise</firstname><surname>Locock</surname><orcid>0000-0002-8109-1930</orcid><order>17</order></author><author><firstname>Mairead</firstname><surname>Black</surname><orcid>0000-0002-6841-8601</orcid><order>18</order></author><author><firstname>Maria</firstname><surname>Loane</surname><orcid>0000-0002-1206-3637</orcid><order>19</order></author><author><firstname>Ngawai</firstname><surname>Moss</surname><orcid>0000-0001-9369-5072</orcid><order>20</order></author><author><firstname>Rachel</firstname><surname>Plachcinski</surname><orcid>0000-0001-9908-0773</orcid><order>21</order></author><author><firstname>Shakila</firstname><surname>Thangaratinam</surname><orcid>0000-0002-4254-460x</orcid><order>22</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>23</order></author><author><firstname>Utkarsh</firstname><surname>Agrawal</surname><orcid>0000-0001-5181-6120</orcid><order>24</order></author><author><firstname>Zoe</firstname><surname>Vowles</surname><orcid>0000-0001-6989-2180</orcid><order>25</order></author><author><firstname>Peter</firstname><surname>Brocklehurst</surname><orcid>0000-0002-9950-6751</orcid><order>26</order></author><author><firstname>Helen</firstname><surname>Dolk</surname><orcid>0000-0001-6639-5904</orcid><order>27</order></author><author><firstname>Catherine</firstname><surname>Nelson-Piercy</surname><orcid>0000-0001-9311-1196</orcid><order>28</order></author><author><firstname>Krishnarajah</firstname><surname>Nirantharakumar</surname><orcid>0000-0002-6816-1279</orcid><order>29</order></author><author><firstname>(on behalf of the MuM-PreDiCT</firstname><surname>Group)</surname><order>30</order></author></authors><documents><document><filename>66424__30372__b62b330a8e774fc0bb24560894631253.pdf</filename><originalFilename>66424.pdf</originalFilename><uploaded>2024-05-15T08:44:33.8188307</uploaded><type>Output</type><contentLength>1376818</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is licensed under a Creative Commons Attribution 4.0 International License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
spelling |
v2 66424 2024-05-15 Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2024-05-15 MEDS BackgroundThe number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy.MethodsA retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register.Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period.Logistic regression models were performed to identify risk factors for polypharmacy.ResultsDuring the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%.Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs).Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14–1.18) and 1.55 (1.53–1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33–2.47), 1.71 (1.65–1.76), 1.41 (1.35–1.47) and 1.39 (1.30–1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18–1.20) and 1.05 (1.03–1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy.ConclusionsThe prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus. Journal Article BMC Medicine 21 1 Springer Science and Business Media LLC 1741-7015 Multiple medications, Polypharmacy, Medications, Prescriptions, Pregnancy, Multimorbidity, Multiple longterm conditions 16 1 2023 2023-01-16 10.1186/s12916-022-02722-5 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was funded by the Strategic Priority Fund “Tackling multimorbidity at scale” programme [grant number MR/W014432/1] delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council. BT was funded by the National Institute for Health Research (NIHR) West Midlands Applied Research Collaboration. AA, KP and SIL were funded as NIHR Academic Clinical Fellows. The views expressed are those of the authors and not necessarily those of the funders, the NIHR or the UK Department of Health and Social Care. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. 2024-06-19T15:52:47.0667175 2024-05-15T08:41:26.7533659 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Anuradhaa Subramanian 0000-0001-8875-7363 1 Amaya Azcoaga-Lorenzo 0000-0003-3307-878x 2 Astha Anand 0000-0003-0494-321x 3 Katherine Phillips 0000-0003-0674-605x 4 Siang Ing Lee 0000-0002-2332-5452 5 Neil Cockburn 0000-0001-9284-6991 6 Adeniyi Francis Fagbamigbe 0000-0001-9184-8258 7 Christine Damase-Michel 0000-0001-5018-0108 8 Christopher Yau 0000-0001-7615-8523 9 Colin McCowan 0000-0002-9466-833x 10 Dermot O’Reilly 0000-0002-9181-0652 11 Gillian Santorelli 0000-0003-0427-1783 12 Holly Hope 0000-0002-4834-6719 13 Jonathan I. Kennedy 0000-0002-1122-6502 14 Kathryn M. Abel 0000-0003-3538-8896 15 Kelly-Ann Eastwood 0000-0003-3689-0490 16 Louise Locock 0000-0002-8109-1930 17 Mairead Black 0000-0002-6841-8601 18 Maria Loane 0000-0002-1206-3637 19 Ngawai Moss 0000-0001-9369-5072 20 Rachel Plachcinski 0000-0001-9908-0773 21 Shakila Thangaratinam 0000-0002-4254-460x 22 Sinead Brophy 0000-0001-7417-2858 23 Utkarsh Agrawal 0000-0001-5181-6120 24 Zoe Vowles 0000-0001-6989-2180 25 Peter Brocklehurst 0000-0002-9950-6751 26 Helen Dolk 0000-0001-6639-5904 27 Catherine Nelson-Piercy 0000-0001-9311-1196 28 Krishnarajah Nirantharakumar 0000-0002-6816-1279 29 (on behalf of the MuM-PreDiCT Group) 30 66424__30372__b62b330a8e774fc0bb24560894631253.pdf 66424.pdf 2024-05-15T08:44:33.8188307 Output 1376818 application/pdf Version of Record true This article is licensed under a Creative Commons Attribution 4.0 International License. true eng https://creativecommons.org/licenses/by/4.0/ |
title |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
spellingShingle |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 Sinead Brophy |
title_short |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
title_full |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
title_fullStr |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
title_full_unstemmed |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
title_sort |
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
author_id_str_mv |
84f5661b35a729f55047f9e793d8798b |
author_id_fullname_str_mv |
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy |
author |
Sinead Brophy |
author2 |
Anuradhaa Subramanian Amaya Azcoaga-Lorenzo Astha Anand Katherine Phillips Siang Ing Lee Neil Cockburn Adeniyi Francis Fagbamigbe Christine Damase-Michel Christopher Yau Colin McCowan Dermot O’Reilly Gillian Santorelli Holly Hope Jonathan I. Kennedy Kathryn M. Abel Kelly-Ann Eastwood Louise Locock Mairead Black Maria Loane Ngawai Moss Rachel Plachcinski Shakila Thangaratinam Sinead Brophy Utkarsh Agrawal Zoe Vowles Peter Brocklehurst Helen Dolk Catherine Nelson-Piercy Krishnarajah Nirantharakumar (on behalf of the MuM-PreDiCT Group) |
format |
Journal article |
container_title |
BMC Medicine |
container_volume |
21 |
container_issue |
1 |
publishDate |
2023 |
institution |
Swansea University |
issn |
1741-7015 |
doi_str_mv |
10.1186/s12916-022-02722-5 |
publisher |
Springer Science and Business Media LLC |
college_str |
Faculty of Medicine, Health and Life Sciences |
hierarchytype |
|
hierarchy_top_id |
facultyofmedicinehealthandlifesciences |
hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
department_str |
Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science |
document_store_str |
1 |
active_str |
0 |
description |
BackgroundThe number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy.MethodsA retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register.Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period.Logistic regression models were performed to identify risk factors for polypharmacy.ResultsDuring the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%.Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs).Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14–1.18) and 1.55 (1.53–1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33–2.47), 1.71 (1.65–1.76), 1.41 (1.35–1.47) and 1.39 (1.30–1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18–1.20) and 1.05 (1.03–1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy.ConclusionsThe prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus. |
published_date |
2023-01-16T15:52:46Z |
_version_ |
1802301620716830720 |
score |
11.021648 |