Abstract
Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8 % of pregnancies. The objective of this study is to assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. We identified women aged 15–45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans’ administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7 %, increasing from 5.5 % in 2001 to 7.8 % in 2007. A total of 9.7 % (n = 55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6, 6.7, and 2.4 % respectively. The prevalence of maintenance-only use doubled during the study period from 0.4 to 0.8 %, while rescue-only use decreased from 7.4 to 5.8 %. In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time.
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Abbreviations
- ICS:
-
Inhaled corticosteroid
- LABA:
-
Long acting beta agonist
- LMP:
-
Last menstrual period
- LRA:
-
Leukotriene receptor antagonist
- MEPREP:
-
Medication Exposure in Pregnancy Risk Evaluation Program
- SABA:
-
Short acting beta agonist
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Acknowledgments
We would like to thank Group Health Research Institute (Washington), Harvard Pilgrim Health Care Institute (Massachusetts), HealthPartners Research Foundation (Minnesota), Kaiser Permanente Colorado, Kaiser Permanente Northwest (Oregon, Washington), Meyers Primary Care Institute (Massachusetts), Lovelace Clinic Foundation (New Mexico), Kaiser Permanente Northern California, Kaiser Permanente Southern California, TennCare Bureau, and the Tennessee Department of Health for providing study data. We would also like to thank the MEPREP programmers at each site for their time and effort in extracting the data. This study was supported through funding from contracts HHSF223200510012C, HHSF223200510009C, and HHSF223200510008C from the U.S. Food and Drug Administration (Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research). Dr. Dublin was supported by National Institute on Aging grant K23AG028954. Birth certificate data for each site was provided by the corresponding State Department of Health, we appreciate their collaborations.
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The views expressed in this paper are those of the authors and are not intended to convey official U.S. Food and Drug Administration (FDA) policy or guidance. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health.
Appendix
Appendix
List of asthma medications
Maintenance medications | |
---|---|
Combinations (ICS and LABA) | Mast cell stabilizers |
BUDESONIDE/FORMOTEROL | CROMOLYN |
FLUTICASONE/SALMETEROL | NEDOCROMIL |
Inhaled corticosteroids (ICS) | Long acting beta-agonists (LABA) |
BECLOMETHASONE | ARFORMOTEROL |
BUDESONIDE | FORMOTEROL |
FLUNISOLIDE | SALMETEROL |
FLUNISOLIDE/MENTHOL | |
FLUTICASONE | Leukotriene antagonist (LRA) |
MOMETASONE | MONTELUKAST |
TRIAMCINOLONE | ZAFIRLUKAST |
ZILEUTON | |
Methylxanthines | |
AEROLATE | THEOP/ISOPROTERENOL/EPD/KI/PB |
AMINOPHYLLIN/EPHED/POT IOD/PB | THEOPHYLL/CAFF/AA13/CINN/HC135 |
AMINOPHYLLINE | THEOPHYLL/EPHED HCL/PHENOBARB |
AMINOPHYLLINE/EPHED/AMOBARB | THEOPHYLL/EPHED/BUTABARBITAL |
AMINOPHYLLINE/EPHED/PHENOBARB | THEOPHYLL/EPHED/POT IODIDE/PB |
AMINOPHYLLINE/EPHEDRINE | THEOPHYLLINE |
AMINOPHYLLINE/PHENOBARB | THEOPHYLLINE-EPHED-BUTABA |
AMINOPHYLLINE/QUININE | THEOPHYLLINE-EPHED-PHENOB |
DYPHYLLINE | THEOPHYLLINE-EPHEDRINE |
DYPHYLLINE-EPHEDRINE-PHEN | THEOPHYLLINE-EPHEDRINE-GG |
GUAIFEN/DYPHYLLIN/EPHED/PB | THEOPHYLLINE-EPHEDRINE-PB |
GUAIFEN/THEOP ANHYD/P-EPHED | THEOPHYLLINE-GUAIFENESIN |
GUAIFENESIN/DYPHYLLINE | THEOPHYLLINE-IODINATED GL |
GUAIFENESIN/OXTRIPHYLLINE | THEOPHYLLINE-KI |
GUAIFENESIN/THEOPHYLLINE | THEOPHYLLINE-PSE-GG |
OXTRIPHYLLINE | THEOPHYLLINE/DIETARY SUP.CMB9 |
OXTRIPHYLLINE-GUAIFENESIN | THEOPHYLLINE/EPHED/HYDROXYZINE |
THEOPHYLLINE/POTASSIUM IODIDE | |
Rescue medications | |
Combinations | Short acting beta-agonists |
IPRATROPIUM/ALBUTEROL | ALBUTEROL |
BITOLTEROL | |
Anticholinergics | ISOETHARINE |
IPRATROPIUM | ISOPROTERENOL |
TIOTROPIUM | |
LEVALBUTEROL | |
METAPROTERENOL | |
PIRBUTEROL | |
TERBUTALINE |
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Hansen, C., Joski, P., Freiman, H. et al. Medication Exposure in Pregnancy Risk Evaluation Program: The Prevalence of Asthma Medication Use During Pregnancy. Matern Child Health J 17, 1611–1621 (2013). https://doi.org/10.1007/s10995-012-1173-x
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DOI: https://doi.org/10.1007/s10995-012-1173-x