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Coulm B, Beghin D, Latour M, Majed B, Vauzelle C, Elefant E, Marin B. [The new version of the French teratology information service "CRAT" website]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024:S2468-7189(24)00230-7. [PMID: 38844060 DOI: 10.1016/j.gofs.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
The Centre de Référence sur les Agents Tératogènes (CRAT) is a unique French national reference center involved in the risk assessment of exogenous agents (mainly drugs, but also medical imaging and addictions) on pregnancy, breastfeeding and fertility. To help improve patient care, CRAT makes its expertise available to healthcare professionals via its website (www.lecrat.fr), a free, independent and public online resource regularly updated by its multidisciplinary team. In December 2023, a new version was launched, based on the evolutions desired by the CRAT team and on a satisfaction survey of website's users. A predictive search bar integrated into the home page now enables users to find the specific information they are looking for more quickly. To optimize the access via smartphones, a mobile version is now available.
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Affiliation(s)
- Bénédicte Coulm
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), institut Pierre-Louis d'épidémiologie et de santé publique, hôpital Trousseau, AP-HP, Sorbonne université, Inserm, 75012 Paris, France
| | - Delphine Beghin
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Mathilde Latour
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Bilal Majed
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Catherine Vauzelle
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Elisabeth Elefant
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Benoît Marin
- Département de santé publique, centre de référence sur les agents tératogènes (CRAT), institut Pierre-Louis d'épidémiologie et de santé publique, hôpital Trousseau, AP-HP, Sorbonne université, Inserm, 75012 Paris, France.
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Marin B, Coulm B, Beghin D, Latour M, Béloni P, Toniolo J, Dechartres A, Tubach F, Vauzelle C, Elefant E. [Evaluation of the satisfaction of healthcare professionals using the CRAT website, and launch of a new version]. Therapie 2024:S0040-5957(24)00041-6. [PMID: 38609757 DOI: 10.1016/j.therap.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/11/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
In preparation for a new version of the CRAT (Centre de référence sur les agents tératogènes) website, an evaluation of user satisfaction was carried out. An invitation to complete an online questionnaire covering the various dimensions of the website (appearance, content, interactivity, ease of use, technical performance) was sent in April 2022 to healthcare professionals who referred to CRAT for clinical expertise over the previous two years. After sending out 3224 individual e-mail invitations, 758 evaluators completed the questionnaire in full (response rate: 23.5%). The evaluation revealed a high-level of overall satisfaction among site users (98.0% very satisfied or satisfied). Satisfaction with the site's appearance was also high, although comments were made about the site's lack of a modern web design. Health professionals recognized in their responses the reliable, relevant and up-to-date nature of the content of this free, public online resource, independent of the pharmaceutical industry. On the basis of these highly favorable assessments, with content that has been widely acclaimed and areas for improvement that have caught the attention of site users (evolution of its appearance, of the search tool, implementation of a mobile site), a new version of www.lecrat.fr was launched in the fall of 2023.
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Affiliation(s)
- Benoît Marin
- Inserm, département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, AP-HP, 26, avenue du Dr-Netter, 75012 Paris, France.
| | - Bénédicte Coulm
- Inserm, département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, AP-HP, 26, avenue du Dr-Netter, 75012 Paris, France
| | - Delphine Beghin
- Département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, Sorbonne université, AP-HP, 75012 Paris, France
| | - Mathilde Latour
- Département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, Sorbonne université, AP-HP, 75012 Paris, France
| | - Pascale Béloni
- Inserm U1094, IRD U270, OmegaHealth, EpiMaCT - épidémiologie des maladies chroniques en zone tropicale, institut d'épidémiologie et de neurologie tropicale, université de Limoges, CHU de Limoges, 87100 Limoges, France; Département universitaire de sciences infirmières, université de Limoges, 87100 Limoges, France
| | - Jean Toniolo
- Inserm U1094, IRD U270, OmegaHealth, EpiMaCT - épidémiologie des maladies chroniques en zone tropicale, institut d'épidémiologie et de neurologie tropicale, université de Limoges, CHU de Limoges, 87100 Limoges, France; Département universitaire de sciences infirmières, université de Limoges, 87100 Limoges, France
| | - Agnès Dechartres
- Inserm, département de santé publique, centre de pharmacoépidémiologie (Cephepi), unité de recherche clinique PSL-CFX, CIC-1901, hôpital Pitié Salpêtrière, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, AP-HP, 75013 Paris, France
| | - Florence Tubach
- Inserm, département de santé publique, centre de pharmacoépidémiologie (Cephepi), unité de recherche clinique PSL-CFX, CIC-1901, hôpital Pitié Salpêtrière, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, AP-HP, 75013 Paris, France
| | - Catherine Vauzelle
- Département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, Sorbonne université, AP-HP, 75012 Paris, France
| | - Elisabeth Elefant
- Département de santé publique, Centre de référence sur les agents tératogènes (CRAT), hôpital Trousseau, Sorbonne université, AP-HP, 75012 Paris, France
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Fairlie L, Lavies D, Kalk E, Mhlongo O, Patel F, Technau KG, Mahtab S, Moodley D, Subedar H, Mullick S, Sawry S, Mehta U. Safety surveillance for PrEP in pregnant and breastfeeding women. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1221101. [PMID: 37854936 PMCID: PMC10581206 DOI: 10.3389/frph.2023.1221101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023] Open
Abstract
The risk of HIV acquisition is higher during pregnancy and postpartum than other times. Newly acquired maternal HIV infection associated with high primary viraemia, substantially increases the risk of vertical HIV transmission. Pre-exposure prophylaxis (PrEP) reduces the risk of HIV acquisition. Currently available products include oral tenofovir/emtricitabine (TDF/FTC) and tenofovir alafenamide (TAF)/FTC), long-acting cabotegravir (CAB-LA) and the dapivirine ring (DVR). All except oral TDF/FTC have limited safety data available for use in pregnant and breastfeeding women. The safety of new PrEP agents for pregnant women and the fetus, infant and child, either exposed in utero or during breastfeeding is an ongoing concern for health care workers and pregnant and breastfeeding women, particularly as the safety risk appetite for antiretroviral (ARV) agents used as PrEP is lower in pregnant and breastfeeding women who are HIV-uninfected, compared to women living with HIV taking ARVs as treatment. With the widespread rollout of TDF/FTC among pregnant women in South Africa and other low-middle income countries (LMIC) and the potential introduction of new PrEP agents for pregnant women, there is a need for safety surveillance systems to identify potential signals of risk to either the mother or fetus, measure the burden of such a risk, and where appropriate, provide specific reassurance to PrEP users. Safety data needs to be collected across the continuum of the product life cycle from pre-licensure into the post-marketing period, building a safety profile through both passive and active surveillance systems, recognising the strengths and limitations of each, and the potential for bias and confounding. Pharmacovigilance systems that aim to assess the risk of adverse birth outcomes in pregnant women exposed to PrEP and other agents need to consider the special requirements of pregnancy epidemiology to ensure that the data derived from surveillance are sufficiently robust to inform treatment policies. Here we review the known safety profiles of currently available PrEP candidates in women of child-bearing potential, pregnancy and breastfeeding and discuss pragmatic approaches for such surveillance in HIV-endemic LMICs.
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Affiliation(s)
- Lee Fairlie
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Diane Lavies
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Emma Kalk
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Faeezah Patel
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karl-Günter Technau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Sana Mahtab
- Wits Vaccines & Infectious Diseases Analytics (VIDA) Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Dhayendre Moodley
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | - Saiqa Mullick
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shobna Sawry
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ushma Mehta
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Mothers of children with Down syndrome: a clinical and epidemiological study. J Community Genet 2022; 14:189-195. [PMID: 36562914 PMCID: PMC10104982 DOI: 10.1007/s12687-022-00627-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Down syndrome is the main genetic cause of intellectual disability. Many studies describe the clinical characteristics of DS patients; however, few have investigated the clinical profile of mothers who have children with DS. Advanced maternal age (≥ 35 years old) is a risk factor for DS. Although there is an overall increase in pregnancies among women with advanced maternal age, there is still a lack of awareness of the increased risk of aneuploidy. Here, we reported the clinical and epidemiological profile of DS children and their mothers in a public reference hospital in the State of Rio de Janeiro, Brazil. For data collection, we performed a face-to-face interview guided by a structured questionnaire with closed-ended questions. A total of 344 individuals, 172 mothers and their DS children, were included in this study. Our results show that 56% of the mothers sampled were ≥ 35 years of age at childbirth. Although 98% of them received prenatal care, only 4% obtained a prenatal diagnosis of DS. Most mothers reported not drinking alcohol or smoking cigarettes during pregnancy. Furthermore, 91% of women took prenatal vitamins and supplements; however, 47% were not aware of their benefits for a healthy pregnancy. Given the strict correlation between advanced maternal age and DS, prenatal care should include genetic counseling for women over 35 years of age. This study highlights the importance of prenatal care and the urgent need for better DS screening allowing for immediate postnatal care, positively impacting the life expectancy of these patients.
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Barreau L, Gau S, Loussert L, Vaysse C, Weyl A, Groussolles M. [Cancer during pregnancy: Proposal of a clinical care pathway based on a regional cohort]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:657-665. [PMID: 35843588 DOI: 10.1016/j.gofs.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Cancer during pregnancy affects 1 in 1000 pregnancies. This situation requires multidisciplinary team, however there is no care pathway dedicated to these patients. The main objective was to describe oncological, obstetrical, and neonatal care through a regional inventory. Our secondary objective was to define a regional "cancer and pregnancy" care pathway. MATERIAL AND METHOD We carried out an observational, retrospective study from 2013 to 2019 including 48 women (all cancer types) from 2013 to 2019 in Occitania. Then, we defined an "optimal care pathway" and we assessed whether it was respected in the breast cancer subgroup of our cohort. RESULTS Live births occurred in 79% of the women included. Maternal treatment was initiated during pregnancy for 67% of our population (44% chemotherapy). The most frequent pregnancy complication was preterm delivery (39%), mainly iatrogenic (86.6%). No patient in the group of breast cancer benefited from all of the ten criteria of the "optimal care pathway" that we proposed. CONCLUSIONS A coordinated regional care pathway seems necessary to optimize communication between the healthcare providers (oncologists, gynecologists and multidisciplinary prenatal diagnosis centers, pharmacologists, pediatricians, psychologists, and general practitioners). This study identifies weaknesses in the management of women with cancer during pregnancy and suggests regional improvement opportunities.
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Affiliation(s)
- L Barreau
- Maternité Paule-de-Viguier, CHU Toulouse Purpan, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
| | - S Gau
- Institut du cancer de Montpellier Val d'Aurelle, Parc Euromédecine EU, 208, avenue des Apothicaires, 34090 Montpellier, France.
| | - L Loussert
- Maternité Paule-de-Viguier, CHU Toulouse Purpan, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
| | - C Vaysse
- CHU Toulouse, Institut universitaire du cancer de Toulouse, Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - A Weyl
- CHU Toulouse, Institut universitaire du cancer de Toulouse, Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - M Groussolles
- Maternité Paule-de-Viguier, CHU Toulouse Purpan, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
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Aba Y, Basak T, Sevimli S. The relationship between health literacy and patterns of drug use in pregnancy. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Vabre C, Araujo M, Damase-Michel C, Hurault-Delarue C, Lacroix I. Initial data on the safety of metopimazine during pregnancy and the risk of major birth defects and pregnancy loss - An observational study using the EFEMERIS database. Therapie 2021; 77:405-412. [PMID: 34756562 DOI: 10.1016/j.therap.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/09/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Metopimazine is an anti-emetic drug used to treat nausea and vomiting of pregnancy. However, no animal or clinical data are available regarding its safety in pregnant women. The aim of this study was, therefore, to assess the risk of birth defects and pregnancy loss associated with the use of metopimazine during pregnancy in a population-based cohort study. METHODS The study focused on the EFEMERIS database including the prescription and dispensation of drugs for pregnant women in Haute-Garonne, France, between July 2004 and December 2017. This was an observational, retrospective, comparative study. Pregnancy loss and major birth defects were compared between women exposed to metopimazine during pregnancy and those with no exposure using multivariate logistic regression and Cox proportional risk models. RESULTS Among 135,574 pregnant women, 11,402 (8.2%) were exposed to metopimazine during pregnancy, mostly in the first trimester (more than 70% of women). No association was found between major birth defects and exposure to metopimazine in the first trimester of pregnancy (ORa=[95% CI]=1.06 [0.92-1.23]). Pregnancy loss was negatively associated with metopimazine use during pregnancy (HRa [95% CI]=0.80 [0.72-0.88]), taking into account major potential confounders. Comparable rates were recorded between women exposed to metopimazine and those unexposed to the drug in terms of prematurity (6.7% vs. 6.4%), low birth weight (6.2% vs. 6.2%) and small for gestational age (1.2% vs. 1.4%). CONCLUSION This study illustrates the wide use of metopimazine during pregnancy in France although no studies on efficacy or safety in pregnant women are available. The results of this study do not indicate any teratogenic effect or an increased risk of pregnancy loss of metopimazine.
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Affiliation(s)
- Clémentine Vabre
- REGARDS Network, Medical and Clinical Pharmacology Laboratory, Toulouse University Hospital Centre, INSERM UMR 1295, Toulouse Faculty of Medicine, 37, allées Jules Guesde, 31000 Toulouse, France.
| | - Mélanie Araujo
- REGARDS Network, Medical and Clinical Pharmacology Laboratory, Toulouse University Hospital Centre, INSERM UMR 1295, Toulouse Faculty of Medicine, 37, allées Jules Guesde, 31000 Toulouse, France
| | - Christine Damase-Michel
- REGARDS Network, Medical and Clinical Pharmacology Laboratory, Toulouse University Hospital Centre, INSERM UMR 1295, Toulouse Faculty of Medicine, 37, allées Jules Guesde, 31000 Toulouse, France
| | - Caroline Hurault-Delarue
- REGARDS Network, Medical and Clinical Pharmacology Laboratory, Toulouse University Hospital Centre, INSERM UMR 1295, Toulouse Faculty of Medicine, 37, allées Jules Guesde, 31000 Toulouse, France
| | - Isabelle Lacroix
- REGARDS Network, Medical and Clinical Pharmacology Laboratory, Toulouse University Hospital Centre, INSERM UMR 1295, Toulouse Faculty of Medicine, 37, allées Jules Guesde, 31000 Toulouse, France
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Belleudi V, Fortinguerra F, Poggi FR, Perna S, Bortolus R, Donati S, Clavenna A, Locatelli A, Davoli M, Addis A, Trotta F. The Italian Network for Monitoring Medication Use During Pregnancy (MoM-Net): Experience and Perspectives. Front Pharmacol 2021; 12:699062. [PMID: 34248644 PMCID: PMC8262612 DOI: 10.3389/fphar.2021.699062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
There is an acute need for research to acquire high-quality information on the use of medicines in pregnancy, both in terms of appropriateness and safety. For this purpose, the Italian Medicines Agency established a Network for Monitoring Medication use in pregnancy (MoM-Net) through the conduction of population-based studies using administrative data available at regional level. This paper aimed to describe the experiences and challenges within the network. MoM-Net currently involves eight regions and several experts from public and academic institutions. The first study conducted aimed to identify drug use before, during and after pregnancy investigating specific therapeutic categories, analysing regional variability and monitoring drug use in specific subpopulations (i.e. foreign women/multiple pregnancies). Aggregated demographic, clinical, and prescription data were analysed using a distributed network approach based on common data model. The study population included all women delivering during 2016–2018 in the participating regions (n = 449,012), and corresponding to 59% of deliveries in Italy. Seventy-three per cent of the cohort had at least one drug prescription during pregnancy, compared to 57% before and 59% after pregnancy. In general, a good adherence to guidelines for pregnant women was found although some drug categories at risk of inappropriateness, such as progestins and antibiotics, were prescribed. A strong variability in the use of drugs among regions and in specific subpopulations was observed. The MoM-Net represents a valuable surveillance system on the use of medicines in pregnancy, available to monitor drug categories at high risk of inappropriateness and to investigate health needs in specific regions or subpopulations.
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Affiliation(s)
- Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Francesca R Poggi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health - Istituto di Ricerche Farmacologiche Mario Negri IRCSS, Milan, Italy
| | - Anna Locatelli
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Araujo M, Hurault-Delarue C, Sommet A, Damase-Michel C, Benevent J, Lacroix I. Drug prescriptions in French pregnant women between 2015 and 2016: A study in the EGB database. Therapie 2020; 76:239-247. [PMID: 32736872 DOI: 10.1016/j.therap.2020.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To describe drug prescriptions in pregnant women in France and to identify teratogenic and fetotoxic drug prescriptions. METHODS This study was carried out using data from Échantillon Généraliste des Bénéficiaires (EGB), a French national health database which includes 1/97th of the French population. Our study population included all pregnant women, aged 10 to 60, who were registered in the EGB and had a pregnancy outcome between 2015 and 2016. Drugs prescribed and dispensed to women during pregnancy and the 3 months before, were collected and described for each year and according to pregnancy trimesters. Prescriptions of major teratogen or fetotoxic drugs were described. RESULTS We identified 18,279 pregnancies. Among them, 93% received drug prescriptions and dispensations during pregnancy with an average of 7.4±5.5 different drugs. "Alimentary tract and metabolism (75.4%)", "nervous system (64.0%)" and "blood and blood forming organs (58.7%)" classes were the most frequently prescribed to pregnant women. The 5 most frequently prescribed drugs were paracetamol (60.6%), iron (49.2%), folic acid (45.6%), phloroglucinol (44.0%) and colecalciferol (41.4%). The most commonly prescribed drugs included some that have not yet been well evaluated in pregnancy. Prescriptions and dispensations of teratogenic or fetotoxic drugs, as Non-Steroidal Anti-Inflammatory Drugs and retinoids were observed. Valproic acid prescriptions to pregnant women have become extremely rare. CONCLUSION This descriptive study demonstrates that numerous drugs are prescribed and dispensed to pregnant women in France. These include drugs with a proven teratogenic or fetotoxic effect and many drugs that have not yet been well evaluated in pregnancy.
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Affiliation(s)
- Mélanie Araujo
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical, Clinical Pharmacology Laboratory), Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France.
| | - Caroline Hurault-Delarue
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical, Clinical Pharmacology Laboratory), Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France
| | - Agnès Sommet
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical and Clinical Pharmacology Laboratory), CIC 1436, Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France
| | - Christine Damase-Michel
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical, Clinical Pharmacology Laboratory), Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France
| | - Justine Benevent
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical, Clinical Pharmacology Laboratory), Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France
| | - Isabelle Lacroix
- Réseau REGARDS, Laboratoire de Pharmacologie Médicale et Clinique (Medical, Clinical Pharmacology Laboratory), Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), INSERM UMR 1027, Faculté de Médecine de Toulouse (Toulouse Faculty of Medicine), 37 allées Jules-Guesde, 31000, Toulouse, France
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10
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Chloroquine and hydroxychloroquine during pregnancy: What do we know? Therapie 2020; 75:384-385. [PMID: 32418732 PMCID: PMC7211694 DOI: 10.1016/j.therap.2020.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/05/2020] [Indexed: 11/22/2022]
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Use of triptans during pregnancy? With caution! Therapie 2019; 76:477-478. [PMID: 31924306 DOI: 10.1016/j.therap.2019.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 10/22/2019] [Accepted: 12/12/2019] [Indexed: 12/20/2022]
Abstract
We report cases, registered in the French national pharmacovigilance database, of fetal death and intrauterine growth retardation in women exposed to triptans during pregnancy. Triptans have vasoconstrictive properties and we wonder about their responsibility for these side effects. The use of triptans and other drugs exhibiting vasoconstrictive properties in pregnant women requires a careful benefits/risks evaluation.
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[Evaluation and impact of "pregnancy" pharmaceutical pictograms among 281 women]. Therapie 2019; 75:449-458. [PMID: 31831186 DOI: 10.1016/j.therap.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/08/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022]
Abstract
In France, since 2017 new pharmaceutical pictograms appeared on drugs with a potentieal risk during pregnancy. This apposition, left to the discretion of marketing authorization holders, has uncertain consequences for women's reactions to them. The present survey is the first one interested in the opinion of the women concerned (pregnant or of childbearing age) as well as on the interpretation that they make of it. The survey answers enhanced that the pregnancy pictogram is an initiative welcomed by women who estimate that it secures drug intake. However, we demonstrate a poor understanding of the message conveyed by these pictograms (more than 50 % think they concern breastfeeding and more than 10 % fertility) and inappropriate behavior towards them (more than 80 of women pregnant stopped or decreased their medication immediately, without medical advice). The survey also highlights the need for information of women concerned by these pictograms and the limited information given by health professionals on this subject. It seems urgent to revise the law, to limite the use of these pictograms that appear to be too broad, incoherent and sometimes unjustified. In addition, public information seems an essential issue when focusing on these new pharmaceutical pictograms.
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