Medication use in pregnancy: a cross-sectional, multinational web-based study

Objectives: Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. his study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design: Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting: Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants: Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures: Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results: The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of ute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than nonimmigrants. Conclusions: In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used

Fetal cystic hygroma associated with terminal 2p25.1 duplication and terminal 3p25.3 deletion: Cytogenetic, fluorescent in situ hybridization and microarray familial characterization of two different chromosomal structural rearrangements

We report a prenatally diagnosed case of partial trisomy 2p and partial monosomy 3p, resulting from unbalanced translocation (2;3)(p25.1;p25.3) of paternal origin. Parents were non consanguineous Caucasians, with familial history of recurrent miscarriages on the father’s side. Detailed sonographic examination of the fetus showed a septated cystic hygroma measuring 6 mm at 13 weeks’ gestation. Karyotyping and fluorescent in situ hybridization (FISH) analysis of cultured amniotic fluid cells revealed an unbalanced translocation der(3)t(2;3)(p25.1; p25.3) and apparently balanced inv(3)(p13p25.3) in a fetus. Parental cytogenetic evaluation using karyotyping and FISH analysis showed the presence of both a balanced translocation and a paracentric inversion in father t(2;3) (p25.1;p25.3) inv(3)(p13p25.3). Microarray analysis showed a 11.6 Mb deletion at 3p26.3-p25.3 and duplication of 10.5 Mb at the 2p25.3-p25 region. The duplicated region at 2p25.1p25.3 contains 45 different genes, where 12 are reported as OMIM morbid genes with different phenotypical implications. The deleted region at 3p26.3-p25.3 contains 65 genes, out of which 27 are OMIM genes

Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study across 12 European countries using the Edinburgh Postnatal Depression Scale

Angela Lupattelli,1 Michael J Twigg,2 Ksenia Zagorodnikova,3 Myla E Moretti,4 Mariola Drozd,5 Alice Panchaud,6,7 Andre Rieutord,8 Romana Gjergja Juraski,9 Marina Odalovic,10 Debra Kennedy,11,12 Gorazd Rudolf,13 Herbert Juch,14 Hedvig Nordeng1,15 1PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy and PharmaTox Strategic Research Initiative, University of Oslo, Oslo, Norway; 2School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, UK; 3Northwest Medical Center for Drug Safety in Pregnancy and Lactation, Northwest State Medical University named after I. I. Mechnikov, St. Petersburg, Russia; 4Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, ON, Canada; 5Department of Applied Pharmacy, Medical University of Lublin, Lublin, Poland; 6School of Pharmaceutical Sciences, University of Geneva and Lausanne, Geneva, Switzerland; 7Division of Clinical Pharmacology and Swiss Teratogen Information Service, Lausanne University Hospital, Lausanne, Switzerland; 8Pharmacy Service, Hospital Antoine-Béclère, GH HUPS, APHP, Clamart France and Européenne de Formation pour les Pharmaciens, Clamart, France; 9Children’s Hospital Srebrnjak, Medical School of Osijek, Josip Juraj Strossmayer University, Osijek, Croatia; 10Faculty of Pharmacy, University of Belgrade, Beograd, Serbia; 11MotherSafe, Royal Hospital for Women, Sydney, NSW, Australia; 12School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia; 13Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia; 14Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University Graz, Graz, Austria; 15Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway Purpose: This study aimed at exploring the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Materials and methods: This was a multinational web-based study conducted across 12 European countries (n=8069). Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate. We used the Edinburgh Postnatal Depression Scale (EPDS) to measure the prevalence of antenatal and postnatal depressive symptoms according to severity, which were corrected by survey weight adjustment (descriptive analysis). Within mothers with a psychiatric disorder (n=173), we estimated the association between antidepressant treatment in pregnancy and postnatal depressive symptom severity, as standardized EPDS mean scores, via the inverse probability of treatment weight (association analysis). Results: In the descriptive analysis (n=8069), the period prevalence of moderate-to-very severe depressive symptoms was higher in the western and eastern regions relative to the northern region, both in the antenatal period (6.8%–7.5% vs 4.3%) and in the postnatal period (7.6% vs 4.7%). One in two mothers with psychiatric disorders used an antidepressant in pregnancy (86 of 173). In the association analysis, women medicated at any time during pregnancy (adjusted β=−0.34, 95% confidence interval [CI] =−0.66, −0.02) had a significant postnatal symptom severity reduction compared with the nonmedicated counterpart. This effect was larger (β=−0.74, 95% CI =−1.24, −0.24) when the analysis was restricted to mothers within 6 months after childbirth. Conclusion: The prevalence of self-reported antenatal and postnatal depressive symptoms differs across European countries. Among women with psychiatric disorders, those who had been on treatment with antidepressants during pregnancy were less likely to report postnatal depressive symptoms, particularly within the 6-month period after childbirth, compared with the nonmedicated counterpart. Keywords: antidepressants, pharmacotherapy, pregnancy and postpartum, depression, anxiety, web-base