Article Figures & Data
Tables
- Table 1.
High-Risk Medications Evaluated, Pregnancy Category, and Potential Complications of Use16
Medication Class Medication Name Pregnancy Category Possible Side Effects of Use during Pregnancy HMG-CoA reductase inhibitor atorvastatin simvastatin pravastatin X Studies of several HMG-CoA reductase inhibitors have shown congenital abnormalities in infants and skeletal malformations in rats and mice. Anticonvulsant topiramate X Increased risk for cleft lip and/or cleft palate (oral cleft), hypospadias. Abortions, premature births, low birth weights, and a reduction in live births have also been observed in prospective studies. Anticonvulsant/mood stabilizer valproic acid X and D* Valproic acid syndrome in infants (facial dysmorphology, congenital heart defects, spina bifida, cleft lip and palate, and developmental delays). Antiemetic ondansetron Fetal risk cannot be ruled out Inconsistent findings, possible increased risk of cardiac malformations Selective serotonin reuptake inhibitor paroxetine Fetal risk has been demonstrated Increased risk of major congenital and cardiac malformations and an increased risk of pulmonary hypertension of the newborn, especially with use during the first trimester of pregnancy. Angiotensin converting enzyme inhibitor lisinopril Fetal risk has been demonstrated Increased risk of spontaneous abortion, oligohydramnios, and newborn renal dysfunction. HMG-CoA, 3-hydroxy-3-methyl-glutaryl-coenzyme A.
↵* X for migraine prophylaxis, valproate products; D for epilepsy and bipolar disorder.
- Table 2.
Demographics and Prescribed High-Risk Medications of All Women of Childbearing Age (N = 988) and the Subgroup Excluding Ondansetron (N = 383)
Demographic and Medication Patients on High-Risk Medication High-Risk Subgroup Analysis N (%) N (%) Age (total population) Less than 25 173 (17.5) 30 (7.8) 25 to 34 387 (39.2) 108 (28.2) 35 to 45 428 (43.3) 245 (64.0) Minority status Yes 593 (60.0) 219 (57.2) No 395 (40.0) 164 (42.8) High-risk medications prescribed Lisinopril 195 (19.7) 195 (50.9) Topiramate 94 (9.5) 94 (24.5) Atorvastatin 62 (6.3) 62 (16.2) Paroxetin 34 (3.4) 34 (8.9) Valproic acid 33 (3.3) 33 (8.6) Simvastatin 27 (2.7) 27 (7.1) Pravastatin 10 (1) 10 (2.6) Ondansetron 724 (73.3) — - Table 3.
Women Childbearing Age with Contraception Management, Defined as Taking Reversible Contraception, History of Sterilization, Hysterectomy, or Menopause
Contraception Patients on High-Risk Medication High-Risk Medication Subgroup Analysis N = 988 N = 383 N (%) N (%) No contraception 540 (54.7) 237 (61.9) Contraception management Reversible contraception 367 (37.2) 115 (30.0) Sterilization (tubal ligation/hysterectomy) 27 (2.7) 7 (1.8) Postmenopausal 54 (5.5) 24 (6.3) - Table 4.
Odds of Having Contraceptive Management When Being Prescribed a High-Risk Medication for the Overall Study Population and Subgroup, Excluding Ondansetron, Controlling for Patient Age
Age High-Risk Medication Prescribed N, % Adjusted ORs 95% CIs P Value Overall study population <25 173, 18 0.47 0.34 to 0.66 <.001 25 to 34 387, 39 0.82 0.65 to 1.03 .09 35 to 45 428, 43 1.18 0.93 to 1.50 .18 Subgroup excluding ondansetron <25 30, 8 0.86 0.42 to 1.79 .69 25 to 34 108, 28 0.75 0.50 to 1.10 .14 35 to 45 245, 64 1.44 1.07 to 1.94 .02 CIs, confidential intervals; ORs, odd ratios.
