Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO)
BackgroundEpilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.MethodsThis study analyzed trends in ASMs use among pregnant...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1469552/full |
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| author | Payam Peymani Anick Berard Anick Berard Brandace Winquist Padma Kaul Padma Kaul Odile Sheehy Alekhya Lavu Christine Leong Christine Leong Jamie Falk Joseph A. Delaney Joseph A. Delaney Kaarina Kowalec Kaarina Kowalec Marcus Ng Chelsea Ruth Chelsea Ruth Laila Aboulatta Silvia Alessi-Severini Silvia Alessi-Severini Roxana Dragan Shelley Derksen Olesya Barrett Golnaz Shams Sherif Eltonsy Sherif Eltonsy |
| author_facet | Payam Peymani Anick Berard Anick Berard Brandace Winquist Padma Kaul Padma Kaul Odile Sheehy Alekhya Lavu Christine Leong Christine Leong Jamie Falk Joseph A. Delaney Joseph A. Delaney Kaarina Kowalec Kaarina Kowalec Marcus Ng Chelsea Ruth Chelsea Ruth Laila Aboulatta Silvia Alessi-Severini Silvia Alessi-Severini Roxana Dragan Shelley Derksen Olesya Barrett Golnaz Shams Sherif Eltonsy Sherif Eltonsy |
| author_sort | Payam Peymani |
| collection | DOAJ |
| description | BackgroundEpilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.MethodsThis study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 years (Manitoba, Saskatchewan, Alberta, and Quebec). Descriptive statistics were utilized to examine the characteristics of the population, with the frequency and patterns of ASM use estimated throughout each trimester. Linear regression models were developed to analyze yearly patterns of ASM utilization for the overall study population, as well as for people with and without epilepsy.ResultsAmong 1,317,141 pregnant individuals across four provinces, 0.7% had epilepsy. Of the total pregnancies, 1.7% (n = 22,783) were exposed to ASMs, comprising 4,392 from pregnant people with epilepsy (PPWE) and 18,391 from those without epilepsy (PPWOE). Results demonstrated varying trends in ASM usage between provinces, with an overall increase in usage among people without epilepsy in Manitoba, Saskatchewan, and Alberta. ASM use among PPWOE surged significantly in Manitoba (24.2–149.1 per 10,000 pregnant people), Saskatchewan (29.4–107.0 per 10,000), and Alberta (65.7–241.7 per 10,000) (p < 0.05). In Alberta, PPWE’s ASM exposure also rose, from 23.6 in 2008 to 43.0 per 10,000 pregnant people in 2021, while Quebec witnessed a decrease from 59.2 in 1998 to 45.5 per 10,000 pregnancies in 2015. Analysis of ASM use by trimester illustrated a substantial decline among PPWOE from 365 days pre-pregnancy to the third trimester in all provinces. ASM utilization by drug class showcased significant shifts, with second-generation ASMs experiencing a notable rise. Carbamazepine, once prominent, declined, making way for lamotrigine. Regional variations underscore diverse preferences, such as clonazepam’s sustained popularity in Manitoba and Quebec.ConclusionThe study identified increasing trends in ASM use, particularly the increased use of second-generation ASMs, and differences in prescription patterns for pregnant individuals with and without epilepsy. These findings reveal changing ASM use patterns, including increased second-generation ASM use and regional disparities, providing valuable insights into real-world prescription practices. |
| format | Article |
| id | doaj-art-e17fc12bf9b345efa6be33101135056d |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-e17fc12bf9b345efa6be33101135056d2024-11-12T04:39:59ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-11-011510.3389/fphar.2024.14695521469552Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO)Payam Peymani0Anick Berard1Anick Berard2Brandace Winquist3Padma Kaul4Padma Kaul5Odile Sheehy6Alekhya Lavu7Christine Leong8Christine Leong9Jamie Falk10Joseph A. Delaney11Joseph A. Delaney12Kaarina Kowalec13Kaarina Kowalec14Marcus Ng15Chelsea Ruth16Chelsea Ruth17Laila Aboulatta18Silvia Alessi-Severini19Silvia Alessi-Severini20Roxana Dragan21Shelley Derksen22Olesya Barrett23Golnaz Shams24Sherif Eltonsy25Sherif Eltonsy26College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaResearch Center, CHU Sainte-Justine, Montreal, QC, CanadaFaculty of Pharmacy, University of Montreal, Montreal, QC, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaCanadian VIGOUR Center, University of Alberta, Edmonton, AB, CanadaResearch Center, CHU Sainte-Justine, Montreal, QC, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Psychiatry, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartments of Medicine and Epidemiology, University of Washington, Seattle, WA, United StatesCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden0Section of Neurology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada1Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada2Manitoba Centre for Health Policy, Winnipeg, MB, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada2Manitoba Centre for Health Policy, Winnipeg, MB, Canada2Manitoba Centre for Health Policy, Winnipeg, MB, Canada2Manitoba Centre for Health Policy, Winnipeg, MB, Canada3Alberta Health Services, Edmonton, AB, Canada4Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, IranCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada5Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, CanadaBackgroundEpilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.MethodsThis study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 years (Manitoba, Saskatchewan, Alberta, and Quebec). Descriptive statistics were utilized to examine the characteristics of the population, with the frequency and patterns of ASM use estimated throughout each trimester. Linear regression models were developed to analyze yearly patterns of ASM utilization for the overall study population, as well as for people with and without epilepsy.ResultsAmong 1,317,141 pregnant individuals across four provinces, 0.7% had epilepsy. Of the total pregnancies, 1.7% (n = 22,783) were exposed to ASMs, comprising 4,392 from pregnant people with epilepsy (PPWE) and 18,391 from those without epilepsy (PPWOE). Results demonstrated varying trends in ASM usage between provinces, with an overall increase in usage among people without epilepsy in Manitoba, Saskatchewan, and Alberta. ASM use among PPWOE surged significantly in Manitoba (24.2–149.1 per 10,000 pregnant people), Saskatchewan (29.4–107.0 per 10,000), and Alberta (65.7–241.7 per 10,000) (p < 0.05). In Alberta, PPWE’s ASM exposure also rose, from 23.6 in 2008 to 43.0 per 10,000 pregnant people in 2021, while Quebec witnessed a decrease from 59.2 in 1998 to 45.5 per 10,000 pregnancies in 2015. Analysis of ASM use by trimester illustrated a substantial decline among PPWOE from 365 days pre-pregnancy to the third trimester in all provinces. ASM utilization by drug class showcased significant shifts, with second-generation ASMs experiencing a notable rise. Carbamazepine, once prominent, declined, making way for lamotrigine. Regional variations underscore diverse preferences, such as clonazepam’s sustained popularity in Manitoba and Quebec.ConclusionThe study identified increasing trends in ASM use, particularly the increased use of second-generation ASMs, and differences in prescription patterns for pregnant individuals with and without epilepsy. These findings reveal changing ASM use patterns, including increased second-generation ASM use and regional disparities, providing valuable insights into real-world prescription practices.https://www.frontiersin.org/articles/10.3389/fphar.2024.1469552/fullpregnancyantiseizure medicationsepilepsydrug utilizationprescriptionsmonotherapy |
| spellingShingle | Payam Peymani Anick Berard Anick Berard Brandace Winquist Padma Kaul Padma Kaul Odile Sheehy Alekhya Lavu Christine Leong Christine Leong Jamie Falk Joseph A. Delaney Joseph A. Delaney Kaarina Kowalec Kaarina Kowalec Marcus Ng Chelsea Ruth Chelsea Ruth Laila Aboulatta Silvia Alessi-Severini Silvia Alessi-Severini Roxana Dragan Shelley Derksen Olesya Barrett Golnaz Shams Sherif Eltonsy Sherif Eltonsy Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) Frontiers in Pharmacology pregnancy antiseizure medications epilepsy drug utilization prescriptions monotherapy |
| title | Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) |
| title_full | Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) |
| title_fullStr | Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) |
| title_full_unstemmed | Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) |
| title_short | Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO) |
| title_sort | trends of antiseizure medication utilization among pregnant people in four canadian provinces from 1998 to 2023 a study from the canadian mother child cohort active surveillance initiative camcco |
| topic | pregnancy antiseizure medications epilepsy drug utilization prescriptions monotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1469552/full |
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