Conflicts of Interest: Dr Andrade has performed consulting services and received grant support from Pfizer, Merck, Novartis, and GlaxoSmithKline (manufacturers of cardiovascular medications). The grants (funds) received and the work performed are not relevant to the subject matter contained in this manuscript. Dr Platt has conducted unrelated research funded by Glaxo SmithKline, TAP Pharmaceuticals, Sanofi, and Pfizer and has received an honorarium for consulting from Wyeth on an unrelated topic. None of the other authors have potential conflicts of interest with regard to this work.
Outpatient use of cardiovascular drugs during pregnancy†
Version of Record online: 16 JAN 2008
Copyright © 2008 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 17, Issue 3, pages 240–247, March 2008
How to Cite
Andrade, S. E., Raebel, M. A., Brown, J., Lane, K., Livingston, J., Boudreau, D., Rolnick, S. J., Roblin, D., Smith, D. H., Dal Pan, G. J., Scott, P. E. and Platt, R. (2008), Outpatient use of cardiovascular drugs during pregnancy. Pharmacoepidem. Drug Safe., 17: 240–247. doi: 10.1002/pds.1550
- Issue online: 25 FEB 2008
- Version of Record online: 16 JAN 2008
- Manuscript Accepted: 7 DEC 2007
- Manuscript Revised: 26 NOV 2007
- Manuscript Received: 2 MAY 2007
- cardiovascular drugs;
- fetal harm
To provide information on the prevalence of use of cardiovascular drugs, some of which may have fetotoxic or teratogenic effects, in the outpatient setting among pregnant women in the United States.
A retrospective study was conducted using the automated databases of seven health plans participating in the HMO Research Network Center for Education and Research on Therapeutics (CERT). Women who delivered an infant from 1 January 2001 to 31 December 2005 were identified. Cardiovascular drug use was evaluated assuming a gestational duration of 270 days.
During the period 2001 through 2005, 118 935 deliveries were identified that met the criteria for study; 3.1% of women (N = 3672) were dispensed an antihypertensive medication and 0.12% of women (N = 146) were dispensed an antihyperlipidemic medication at any time during pregnancy. The most common antihypertensive drugs dispensed during pregnancy were nifedipine (1219 deliveries; 1.0%), methyldopa (961 deliveries; 0.8%), atenolol (593 deliveries; 0.5%), and labetalol (576 deliveries; 0.5%). Overall, 134 women (0.11%) received an angiotensin converting enzyme (ACE) inhibitor and 7 women (0.006%) received an angiotensin II receptor blocker (ARB) during pregnancy. Statins were the most commonly dispensed antihyperlipidemic drugs (71 deliveries; 0.06%).
The prevalence of use of cardiovascular drugs that are suspected to be fetotoxic or teratogenic (ACE inhibitors, ARBs, and statins) was low in this cohort of pregnant women. Differing patterns of use across health plans suggests that further research is needed to evaluate the potential differential effects of cardiovascular drugs to assist prescribers and patients in making informed treatment decisions. Copyright © 2008 John Wiley & Sons, Ltd.