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Review
. 2023 Jun 15;18(6):e0287111.
doi: 10.1371/journal.pone.0287111. eCollection 2023.

Monitoring medicine prescriptions before, during and after pregnancy in Italy

Filomena Fortinguerra  1 , Valeria Belleudi  2 , Francesca Romana Poggi  2 , Serena Perna  1 , Renata Bortolus  3 , Serena Donati  4 , Paola D'Aloja  4 , Roberto Da Cas  5 , Antonio Clavenna  6 , Anna Locatelli  7 , Antonio Addis  2 , Marina Davoli  2 , Francesco Trotta  1 ; MoM-Net group
Affiliations
Review

Monitoring medicine prescriptions before, during and after pregnancy in Italy

Filomena Fortinguerra et al. PLoS One. .

Abstract

Background: The use of medications during pregnancy is a common event worldwide. Monitoring medicine prescriptions in clinical practice is a necessary step in assessing the impact of therapeutic choices in pregnant women as well as the adherence to clinical guidelines. The aim of this study was to provide prevalence data on medication use before, during and after pregnancy in the Italian population.

Methods: A retrospective prevalence study using administrative healthcare databases was conducted. A cohort of 449,012 pregnant women (15-49 years) residing in eight Italian regions (59% of national population), who delivered in 2016-2018, were enrolled. The prevalence of medication use was estimated as the proportion (%) of pregnant women with any prescription.

Results: About 73.1% of enrolled women received at least one drug prescription during pregnancy, 57.1% in pre-pregnancy and 59.3% in postpartum period. The prevalence of drug prescriptions increased with maternal age, especially during the 1st trimester of pregnancy. The most prescribed medicine was folic acid (34.6%), followed by progesterone (19%), both concentrated in 1st trimester of pregnancy (29.2% and 14.8%, respectively). Eight of the top 30 most prescribed medications were antibiotics, whose prevalence was higher during 2nd trimester of pregnancy in women ≥ 40 years (21.6%). An increase in prescriptions of anti-hypertensives, antidiabetics, thyroid hormone and heparin preparations was observed during pregnancy; on the contrary, a decrease was found for chronic therapies, such as anti-epileptics or lipid-modifying agents.

Conclusions: This study represents the largest and most representative population-based study illustrating the medication prescription patterns before, during and after pregnancy in Italy. The observed prescriptive trends were comparable to those reported in other European countries. Given the limited information on medication use in Italian pregnant women, the performed analyses provide an updated overview of drug prescribing in this population, which can help to identify critical aspects in clinical practice and to improve the medical care of pregnant and childbearing women in Italy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Drug prescriptions by trimester before, during and after pregnancy.
*denominator: pregnancies reaching the 3rd TP (exclusion of deliveries occurred between 20–27 weeks of gestation).
Fig 2
Fig 2. Drug prescriptions trends by ATC group (I level)* before, during and after pregnancy.
* ATC groups with prevalence during pregnancy <0,5% were excluded.
Fig 3
Fig 3. Ranking of the most 10 prescribed drugs during pregnancy overall and by maternal age group.
See this image and copyright information in PMC

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