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Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Background

Medication use during pregnancy and lactation is prevalent. However, current knowledge of the risks and benefits of medication use during pregnancy and lactation is incomplete as the best available evidence has been obtained from cohort studies of inadvertent exposures and registries. This situtation may partly explain health care providers’ (HCP) risk perceptions and thus the increasing number of calls to Teratogen Information Services (TIS).

Objectives

The objectives of this study were (1) to identify the medication classes for which HCP are seeking counseling from the IMAGe center, a Quebec TIS; (2) to identify the medical conditions for which medication classes were used during pregnancy and lactation; (3) to identify and quantify predictors of medication information requests during pregnancy and lactation.

Methods

A retrospective analysis of data was conducted within the population served by the IMAGe center, a TIS based at CHU Ste-Justine in Montreal, Quebec, Canada, that serves the French population of Canada. To be included, calls had to be received between January 1, 2004 and April 30, 2007, and the subject of the call had to be directly associated with the exposure, or not, of a pregnant or breastfeeding woman to medication. Multivariate generalized estimating equation (GEE) regression models were performed to identify the predictors of medication requests.

Results

A total of 11, 076 requests regarding medication exposure during pregnancy, 12 055 requests regarding pregnant women before the exposure took place, and 13, 364 requests regarding lactation were included for analyses. Pregnant women were most frequently exposed to antidepressants (17.3), antibiotics (6.3%), and benzodiazepines (5.3%). Prior to drug exposure, the most frequent inquiries by HCP were on antibiotics (11.0%), anti-inflammatory drugs (6.0%), and antiemetics (5.1%). Inquiries concerning lactating women most frequently requested information on the drug classes of antidepressants (10.8%), antibiotics (9.1%), and anti-inflammatory drugs (7.8%). Depressive disorders were an indication of antidepressant, benzodiazepine and antipsychotic exposures reported to IMAGe. Associations were found between medication use and maternal age, previous pregnancies, trimester of pregnancy at the time of the call and lifestyle habits.

Conclusions

The IMAGe received frequent inquiries on antidepressant, antibiotic, and benzodiazepine exposures, with depressive disorders being the most frequently declared indication. Predictors of medication requests were identified among exposed women during pregnancy, and breastfeeding women. These results emphasize the need for effective studies on drug use during pregnancy and lactation and for better knowledge transfer programs.

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Acknowledgments

The infrastructure used for this study was supported by the Canadian Foundation for Innovation (CFI). Marie-Pierre Gendron is the recipient of a Master’s research bursary from the CHU Sainte-Justine’s Foundation and the Foundation for Research into Children’s Diseases (Foundation of Stars). Dr. Anick Bérard is the recipient of a career award from the Canadian Institutes of Health Research (CIHR)/Health Research Foundation and is on the endowment research Chair of the Famille Louis-Boivin on ‘Medications, Pregnancy, and Lactation’ at the Faculty of Pharmacy of the University of Montreal.

Conflict of Interest

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada

    Marie-Pierre Gendron & Anick Bérard

  2. Research Center, CHU Sainte-Justine, 3175, Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Marie-Pierre Gendron, Driss Oraichi & Anick Bérard

  3. Department of Pharmacy, CHU Sainte-Justine, Montreal, QC, Canada

    Brigitte Martin

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  1. Marie-Pierre Gendron
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Correspondence to Anick Bérard.

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Gendron, MP., Martin, B., Oraichi, D. et al. Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation. Eur J Clin Pharmacol 65, 523–531 (2009). https://doi.org/10.1007/s00228-008-0611-6

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  • DOI: https://doi.org/10.1007/s00228-008-0611-6

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