gms | German Medical Science

11. Jahrestagung 2004 der GAA

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

30.09. bis 01.10.2004, Jena

Drug prescription in pregnancy: methodological aspects of the analysis of sickness fund data

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker V. Egen-Lappe - Institute for Medical Informatics, Biometry and Epidemiology (IBE), University of Munich
  • J. Hasford - Institute for Medical Informatics, Biometry and Epidemiology (IBE), University of Munich
  • C. Strunz-Lehner - Institute for Medical Informatics, Biometry and Epidemiology (IBE), University of Munich

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA) e.V.. 11. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Jena, 30.09.-01.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gaa02

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Veröffentlicht: 30. September 2004

© 2004 Egen-Lappe et al.
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During the past twenty years in Germany there have only been four studies of moderate size and regional focus on general drug use in pregnancy. The co-operation with German sickness funds allowed for the first time to analyse the prescription data of large, nation-wide cohorts of pregnant women.

Aim of the Study

The study aimed at evaluating the appropriateness of sickness fund data for the analysis of drug prescribing in pregnancy and of the risk potential of drugs during this period by linkage with the outcome data of the perinatal study.

Description of Methods and Results

Data of two nation-wide active substitute sickness funds (41,293 and 8,552 women) and a public sickness fund (6,792 women mainly of Bavaria) were available. The women gave birth within a one-year-period between January 2000 and December 2001. The study population of 56,637 women corresponded to 7,5% of the yearly births in Germany.

The sickness fund identified the pregnant women by the reimbursement of a delivery. Prescription data were available for 270 days before birth (three trimesters 90 days each) and 180 days before and after pregnancy. For analysis of drug prescription only women insured throughout the whole study period could be included (81.4%). These women were somewhat more often self-insured (77% vs. 72%) than family-insured. There were no relevant differences for the other demographic variables, e.g. age, state of residence, social status.

The data of 5,266 women of one of the substitute sickness funds, who had given birth in Bavaria, could be linked to the Bavarian perinatal study (71% of 7,385 possible cases). The perinatal study covers about 90% of births and identifies a rate of 1,7 malformations per one hundred births.

Discussion and Conclusion

Data of sickness funds are appropriate to analyse drug prescription during and around pregnancy with regard to quantity and quality. Also changes over time can be made visible. All prescriptions reimbursed by the women are covered. In contrast to interview- or diary-based studies they are not impaired by recall bias and refusal of participation. For analysing teratogenic risks of drugs large cohorts of pregnant women are needed which can only be provided by health care databases in a time- and cost-effective manner. Since data on self-medication and compliance are lacking and the focus of the perinatal study on malformations is limited there is room for improvement. However, in a situation where information on the safety of drugs during pregnancy is extremely limited routinely collected health care data can make a valuable contribution to identify potential teratogenes.

Conflict of Interest Statement

There were no conflicts of interest. The study was funded by the Deutsche Forschungsgemeinschaft (DFG) (German Research Foundation), a central, self-governing research organisation that promotes research at universities and other publicly financed research institutions in Germany (project identification no. 26661).