TY - JOUR
T1 - Selective serotonin reuptake inhibitor prescribing before, during and after pregnancy
T2 - a population-based study in six European regions
AU - Charlton, R. A.
AU - Jordan, S.
AU - Pierini, A.
AU - Garne, E.
AU - Neville, A. J.
AU - Hansen, A. V.
AU - Gini, R.
AU - Thayer, D.
AU - Tingay, K.
AU - Puccini, A.
AU - Bos, H. J.
AU - Nybo Andersen, A. M.
AU - Sinclair, M.
AU - Dolk, H.
AU - De Jong-Van Den Berg, L. T W
PY - 2015/6
Y1 - 2015/6
N2 - Objective To explore the prescribing patterns of selective serotonin reuptake inhibitors (SSRIs) before, during and after pregnancy in six European population-based databases. Design Descriptive drug utilisation study. Setting Six electronic healthcare databases in Denmark, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Population All women with a pregnancy ending in a live or stillbirth starting and ending between 2004 and 2010. Methods A common protocol was implemented across databases to identify SSRI prescriptions issued (UK) or dispensed (non-UK) in the year before, during or in the year following pregnancy. Main outcome measures The percentage of deliveries in which the woman received an SSRI prescription in the year before, during or in the year following pregnancy. We also compared the choice of SSRIs and changes in prescribing over the study period. Results In total, 721 632 women and 862 943 deliveries were identified. In the year preceding pregnancy, the prevalence of SSRI prescribing was highest in Wales [9.6%; 95% confidence interval (CI95), 9.4-9.8%] and lowest in Emilia Romagna (3.3%; CI95, 3.2-3.4%). During pregnancy, SSRI prescribing had dropped to between 1.2% (CI95, 1.1-1.3%) in Emilia Romagna and 4.5% (CI95, 4.3-4.6%) in Wales. The higher UK pre-pregnancy prescribing rates resulted in higher first trimester exposures. After pregnancy, SSRI prescribing increased most rapidly in the UK. Paroxetine was more commonly prescribed in the Netherlands and Italian regions than in Denmark and the UK. Conclusions The higher SSRI prescribing rates in the UK, compared with other European regions, raise questions about differences in the prevalence and severity of depression and its management in pregnancy across Europe.
AB - Objective To explore the prescribing patterns of selective serotonin reuptake inhibitors (SSRIs) before, during and after pregnancy in six European population-based databases. Design Descriptive drug utilisation study. Setting Six electronic healthcare databases in Denmark, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Population All women with a pregnancy ending in a live or stillbirth starting and ending between 2004 and 2010. Methods A common protocol was implemented across databases to identify SSRI prescriptions issued (UK) or dispensed (non-UK) in the year before, during or in the year following pregnancy. Main outcome measures The percentage of deliveries in which the woman received an SSRI prescription in the year before, during or in the year following pregnancy. We also compared the choice of SSRIs and changes in prescribing over the study period. Results In total, 721 632 women and 862 943 deliveries were identified. In the year preceding pregnancy, the prevalence of SSRI prescribing was highest in Wales [9.6%; 95% confidence interval (CI95), 9.4-9.8%] and lowest in Emilia Romagna (3.3%; CI95, 3.2-3.4%). During pregnancy, SSRI prescribing had dropped to between 1.2% (CI95, 1.1-1.3%) in Emilia Romagna and 4.5% (CI95, 4.3-4.6%) in Wales. The higher UK pre-pregnancy prescribing rates resulted in higher first trimester exposures. After pregnancy, SSRI prescribing increased most rapidly in the UK. Paroxetine was more commonly prescribed in the Netherlands and Italian regions than in Denmark and the UK. Conclusions The higher SSRI prescribing rates in the UK, compared with other European regions, raise questions about differences in the prevalence and severity of depression and its management in pregnancy across Europe.
KW - Drug utilisation
KW - electronic health records
KW - pregnancy
KW - serotonin uptake inhibitors
UR - http://www.scopus.com/inward/record.url?scp=84930017541&partnerID=8YFLogxK
UR - http://dx.doi.org/10.1111/1471-0528.13143
U2 - 10.1111/1471-0528.13143
DO - 10.1111/1471-0528.13143
M3 - Article
AN - SCOPUS:84930017541
SN - 1470-0328
VL - 122
SP - 1010
EP - 1020
JO - BJOG : An International Journal Of Obstetrics & Gynaecology
JF - BJOG : An International Journal Of Obstetrics & Gynaecology
IS - 7
ER -