The Quebec Pregnancy Cohort--prevalence of medication use during gestation and pregnancy outcomes.

We evaluated the potential and the validity of the Quebec Pregnancy Cohort (QPC) as a research tool in perinatal pharmacoepidemiology.The QPC was built by linking four administrative databases: RAMQ (medical and pharmaceutical data), Med-Echo (hospitalizations), ISQ (births/deaths), and MELS (Ministry of Education data). A self-administered questionnaire was sent to a random sample of women to collect lifestyle information. The QPC includes data on all pregnancies of women covered by the Quebec provincial prescription drug insurance between 1998 and 2008. Date of entry in the QPC is the first day of pregnancy, and women are followed during and after pregnancy; children are followed after birth up until 2009. The prevalence of prescribed medications before, during and after pregnancy was compared between time-window. Pregnancy outcomes were also estimated among pregnancies ending with a live born infant.The QPC included 289,688 pregnancies of 186,165 women. Among them, 167,398 ended with a delivery representing 19.4% of all deliveries occurring in the Province of Quebec between 1998-2009. The total frequency of abortions was 35.9% in the QPC comparable to the 36.4% observed in the Province of Quebec. The prevalence of prescribed medication use was 74.6%, 59.0%, and 79.6% before, during and after pregnancy, respectively. Although there was a statistically significant decrease in the proportion of use once the pregnancy was diagnosed (p<.01), post-pregnancy prescribed medication use returned above the pre-pregnancy level. The prevalence of pregnancy outcomes found in the QPC were similar to those observed in the Province of Quebec.The QPC is an excellent tool for the study of the risk and benefit of drug use during the perinatal period. This cohort has the advantage of including a validated date of beginning of pregnancy giving the possibility of assigning the exact gestational age at the time of maternal exposure

La cohorte des grossesses du Québec : prévalences et conséquences de l’utilisation des médicaments durant la grossesse

Objectif. L’exposition aux médicaments durant la grossesse est fréquente. La cohorte des grossesses du Québec (CGQ) a été créée pour étudier l’effet des médicaments pris pendant la grossesse. Méthodes. Quatre bases de données administratives du Québec, Canada ont été jumelées – médicales, pharmaceutiques, hospitalières, démographiques, scolaires. Les grossesses incluses étaient couvertes par le régime d’assurance médicaments du Québec 12 mois avant et jusqu’à la fin de la grossesse (36 % des femmes de 15 – 45 ans). Résultats. L’analyse inclut 97 680 grossesses. La prévalence d’utilisation des médicaments était 74 % avant, 56 % pendant et 80 % suivant la grossesse. Les médicaments les plus utilisés durant la grossesse étaient : antibiotiques (47 %), antiémétiques (23 %) et anti-inflammatoires non stéroïdiens (AINS) [17 %]. Les utilisatrices étaient plus susceptibles d’avoir une fausse-couche, une naissance prématurée, un enfant avec une malformation congénitale ou une dépression post-partum que les non-utilisatrices (p < 0,01). Conclusion. La prise de médicaments demeure élevée en grossesse. La CGQ est un excellent outil pour la recherche pharmaco-épidémiologique périnatale

Maternal and children characteristics amongst the 3,273 mothers who returned the self-administered questionnaire.

<p>*Because of missing value, some samples are lower than 3,273.</p

Major Congenital malformations by organ system among 155,500 singleton pregnancies.

<p>Major Congenital malformations by organ system among 155,500 singleton pregnancies.</p

The Quebec Pregnancy Cohort: linkage between the administrative databases used and the auto-administered questionnaire.

<p>Abbreviations: Rx, prescription filled; MD/ED, medical and emergency department; SES, social economic status; GA, gestational age; BMI, body mass index; OTC, over-the-counter; ICD-9 and ICD-10, International Classification of Diseases, 9^th and 10^th revision; NAM, Numero d'assurance maladie (unique personal identification number).</p

All prescribed medications combined (including vitamins) during the perinatal period.

<p>All prescribed medications combined (including vitamins) during the perinatal period.</p

Quebec Pregnancy Cohort and outcomes.

<p>Prevalence of pregnancy outcomes during the period 1998–2009.</p

Prescribed medication use by class during pregnancy.

<p>Prescribed medication use by class during pregnancy.</p