Prescription of asthma medications before and during pregnancy in France: An observational drug study using the EFEMERIS database

ABSTRACT

Objective: Asthma affects between 3% to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medications change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France. Methods: Women from the EFEMERIS, a French database assessing the drugs prescribed, dispensed and reimbursed during pregnancy, delivering between July 2004 and December 2012, were included. Women, who were dispensed asthma medications on at least two dates from 3 months prior to pregnancy through delivery, were considered. Results: 2,977 women out of 69,205 (4%) were selected. They were prescribed 2.4 ± 1.2 different anti-asthmatic drugs with 3.5 ± 2.7 different dispensing dates. Almost 62% of the women were dispensed at least one prescription for short-acting β2-agonist (SABA), 63% at least one inhaled corticosteroid (IC), 42% a fixed-combination of an IC and a long-acting β2-agonist (LABA) and 8% a LABA. An increase in SABA and IC prescriptions and a decrease in fixed-combination prescriptions were observed during pregnancy compared to pre-pregnancy period. A rapid drop in prescriptions for montelukast was observed. Among the 1,507 women who were prescribed asthma medication before pregnancy, one third had a drop in dispensed asthma medications from the beginning of pregnancy. Conclusions: The prevalence of dispensed asthma medications varies during pregnancy. There is a decrease in the prescriptions of fixed-combinations during pregnancy and an increase in the prescriptions of ICs. It appears important to study the potential impact of such changes on fetuses and newborns.

KEYWORDS:

• Asthma medication
• drug utilization study
• pregnancy
• EFEMERIS cohort

Acknowledgments

We are grateful to C. Bouilhac, L. Finotto, D. Petiot, C. Vayssière, S. Vidal, and G. Portolan for data collection.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

The EFEMERIS database is funded by the Agence Nationale de Sécurité du Médicament et des produits de santé (ANSM - French Agency for the Safety of Health Products), the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS – French National Health Insurance System for Employees), and the Hospital Clinical Research Programme (PHRC).