Medication Use During Pregnancy in Mainland China: A Cross-Sectional Analysis of a National Health Insurance Database

Abstract

Purpose

This study aims to illustrate the prevalence and patterns of medication use among pregnant women in mainland China.

Patients and methods

Hospital and drugstore service data for a nationally representative sample of basic medical insurance (BMI) beneficiaries in 2015 were obtained from the China Health Insurance Association (CHIRA) database. A total of 7946 women who had singleton deliveries in 2015, aged between 12 and 54, and whose records in the CHIRA database covered at least one trimester were included in this study. We conducted descriptive analyses of sample characteristics, medication use prevalence, and number and types of medications used.

Results

We found that 11.7% of women used at least one medication during the course of pregnancy (median number of medications used = 6.7). Medication use was more common among those who were older, residing in Eastern China, or employed. Most commonly used medication groups by the Anatomical Therapeutic Chemical Classification System were B (Blood and blood forming organs, 49.3%), A (Alimentary tract and metabolism, 48.1%), G (Genito urinary system and sex hormones, 38.1%) and J (Antiinfectives for systemic use, 31.6%). Intravenous solutions, vitamins and minerals, progestogens, and beta-lactam antibacterials were the most frequently used medications from each of these four ATC groups, respectively. Moreover, 7.1% used at least one medication contraindicated in pregnancy.

Conclusion

This study showed that around one in 10 women used medication during pregnancy in mainland China and found possible cases of inappropriate or unsafe medication use.

Keywords:

• medication use
• pregnancy
• China
• cross-sectional
• health insurance database

Acknowledgments

We are grateful for staff of the China Health Insurance Association (CHIRA) database for their assisting in collecting the data.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. XDG and JYZ conceived the study idea and contributed to the study design. JYZ implemented literature review, cleaned and checked the data, wrote the code, did the analysis for the study. JYZ and COLU wrote the initial draft, and amended the final manuscript. XDG, AKW supervised and checked the analysis, gave suggestions to the initial draft, and reviewed the final manuscript. LWS contributed to data access, supervised the study design and data interpretation, and reviewed the final manuscript.

Funding

This study was supported by the National Natural Science Foundation of China (Grant No. 71774005). The funders were not involved in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The authors had full access to all of the data in the study and had final responsibility for the decision to submit for publication.

Disclosure

The authors report no conflicts of interest in this work.