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    Outpatient use of cardiovascular drugs during pregnancy

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    Authors
    Andrade, Susan E.
    Raebel, Marsha A.
    Brown, Jeffrey S.
    Lane, Kimberly
    Livingston, James
    Boudreau, Denise M.
    Rolnick, Sharon J.
    Roblin, Douglas W.
    Smith, David H.
    Dal Pan, Gerald J.
    Scott, Pamela E.
    Platt, Richard
    Show allShow less
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2008-03-18
    Keywords
    Adolescent
    Adult
    Angiotensin II Type 1 Receptor Blockers
    Angiotensin-Converting Enzyme Inhibitors
    Antihypertensive Agents
    Cardiovascular Agents
    Databases, Factual
    Female
    Health Maintenance Organizations
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    use
    Hypolipidemic Agents
    Middle Aged
    Outpatients
    Pregnancy
    Pregnancy Complications, Cardiovascular
    Prevalence
    Retrospective Studies
    Teratogens
    United States
    Health Services Research
    Maternal and Child Health
    Primary Care
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    Link to Full Text
    http://dx.doi.org/10.1002/pds.1550
    Abstract
    PURPOSE: To provide information on the prevalence of use of cardiovascular drugs, some of which may have fetotoxic or teratogenic effects, in the outpatient setting among pregnant women in the United States. METHODS: A retrospective study was conducted using the automated databases of seven health plans participating in the HMO Research Network Center for Education and Research on Therapeutics (CERT). Women who delivered an infant from 1 January 2001 to 31 December 2005 were identified. Cardiovascular drug use was evaluated assuming a gestational duration of 270 days. RESULTS: During the period 2001 through 2005, 118,935 deliveries were identified that met the criteria for study; 3.1% of women (N = 3672) were dispensed an antihypertensive medication and 0.12% of women (N = 146) were dispensed an antihyperlipidemic medication at any time during pregnancy. The most common antihypertensive drugs dispensed during pregnancy were nifedipine (1219 deliveries; 1.0%), methyldopa (961 deliveries; 0.8%), atenolol (593 deliveries; 0.5%), and labetalol (576 deliveries; 0.5%). Overall, 134 women (0.11%) received an angiotensin converting enzyme (ACE) inhibitor and 7 women (0.006%) received an angiotensin II receptor blocker (ARB) during pregnancy. Statins were the most commonly dispensed antihyperlipidemic drugs (71 deliveries; 0.06%). CONCLUSIONS: The prevalence of use of cardiovascular drugs that are suspected to be fetotoxic or teratogenic (ACE inhibitors, ARBs, and statins) was low in this cohort of pregnant women. Differing patterns of use across health plans suggests that further research is needed to evaluate the potential differential effects of cardiovascular drugs to assist prescribers and patients in making informed treatment decisions.
    Source
    Pharmacoepidemiol Drug Saf. 2008 Mar;17(3):240-7. Link to article on publisher's site
    DOI
    10.1002/pds.1550
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37035
    PubMed ID
    18200619
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/pds.1550
    Scopus Count
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