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Trends in anti-infective use during pregnancy in France between 2010 and 2019: A nationwide population-based study.
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  • sarah Tubiana,
  • Jeanne Sibiude,
  • Philippe Herlemont,
  • Jérôme DROUIN,
  • O. Picone,
  • Xavier DUVAL,
  • Alain Weill,
  • Mahmoud Zureik,
  • Rosemary DRAY-SPIRA
sarah Tubiana
AP-HP

Corresponding Author:[email protected]

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Jeanne Sibiude
APHP
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Philippe Herlemont
EPI-PHARE
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Jérôme DROUIN
EPI-PHARE
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O. Picone
APHP
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Xavier DUVAL
APHP
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Alain Weill
EPI-PHARE
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Mahmoud Zureik
ANSM
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Rosemary DRAY-SPIRA
ANSM
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Abstract

Aim. To describe the trends in anti-infective use during pregnancy between 2010 and 2019 and determine whether they were prescribed according to drug fetal safety international classification systems. Methods. We conducted a population-based, nationwide study using the French national health data system including all pregnancies ended between 2010 and 2019. Anti-infective were considered according to their pharmacological group and potential harmful risk using the Australian and Swedish classification systems. Prevalence rate was estimated annually and by trimester. Average annual percent change (AAPC) and 95% confidence intervals (CI) were calculated using Joinpoint regression. Results. Among 7,571,035 pregnancies, 3,027,031 (40.0%) received ≥ 1 antibacterial. This proportion decreased significantly from 41.5% in 2010 to 36.1% in 2019 (AAPC=-1.7%, [95%CI, -2.5% to -1.0%]). Conversely, use of antiviral agents increased during the 10 years’ study period for anti-HSV agents (AAPC=4.4%, [3.7%-5.2%]), influenza agents (AAPC=25.4%, [6.2%-48.1%]), and for HIV-antiretroviral agents (HIV-ART) (AAPC=1.3%, [0.6%-2.0%]). Use of influenza vaccine increased from 0.2% in 2010 to 4.2% in 2019 (AAPC=49.7%, [95%CI, 39.3% to 60.9%]). Among all pregnancies, 0.9% had been exposed to a potentially harmful anti-infective agent increasing from 0.7% in 2010 to 1.2% in 2019 (AAPC=6.4%, [4.4%-8.5 %]). Conclusion. Based on more than 7 million pregnancies identified from French nationwide data, this study showed that antibacterials are frequently prescribed during pregnancy although their use has decreased over the past ten years. Our results suggest that anti-infective are generally prescribed in accordance with recommendations, with however a potential for improvement in influenza vaccination.
03 Jun 2022Submitted to British Journal of Clinical Pharmacology
08 Jun 2022Submission Checks Completed
08 Jun 2022Assigned to Editor
16 Sep 2022Reviewer(s) Assigned
20 Nov 2022Review(s) Completed, Editorial Evaluation Pending
22 Nov 2022Editorial Decision: Revise Minor
25 Nov 20221st Revision Received
26 Nov 2022Submission Checks Completed
26 Nov 2022Assigned to Editor
26 Nov 2022Review(s) Completed, Editorial Evaluation Pending
02 Dec 2022Editorial Decision: Accept
26 Dec 2022Published in British Journal of Clinical Pharmacology. 10.1111/bcp.15638