[Writing and dispensing of NSAID prescriptions in late pregnancy: impact of health authorities' advice].
OBJECTIVE
To evaluate the impact a year afterwards of a letter sent by French health authorities (AFSSAPS) to health care professionals on 12 December 2003 to remind them that late pregnancy is a contraindication to nonsteroidal antiinflammatory drugs (NSAIDs).


METHODS
We used records of the general health insurance fund in the district of Haute-Garonne to study the dispensing of prescription NSAIDS during late pregnancy to women who gave birth in this district both before the letter was sent (n=3099) (before group) and afterwards (2751 women who delivered between 12 July and 12 October 2004: "early after" group) and 2859 women between 12 March and 12 June 2005: "late after" group). We performed a "before-and-after" comparison.


RESULTS
In the before group, 6.6% of the pregnant women had at least one NSAID prescription written and dispensed after the beginning of the sixth month of pregnancy, while this was the case for 5.1% of the women in the "early after" group (p=0.03) and 4.4% of the women in the "late after" group (p=0.004). Moreover, prescriptions and dispensing of paracetamol increased significantly (from 26.8% of the exposed women in 2003 to 36.6% in 2005, p<0.0001).


CONCLUSIONS
The "before-and-after" comparison does not allow us to be sure of the causal link between the recommendations and the changes observed in the writing and dispensing of NSAID prescriptions. Nevertheless, we can hypothesize that this letter contributed to the decrease observed. The reduction is encouraging, but remains insufficient: in 2005, 4.4% of pregnant women were still receiving and filling prescriptions that are potentially harmful to fetuses and neonates.
Hurault
Caroline
C
Service de pharmacologie clinique, Unité Médicaments, grossesse et allaitement, Centre Hospitalier Universitaire, EA 3696 Université de Toulouse, F-31000 Toulouse, France.
Lacroix
Isabelle
I
Bourrel
Robert
R
Montastruc
Jean-Louis
JL
Damase-Michel
Christine
C
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D000075202:Contraindications; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006291:Health Policy; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D011247:Pregnancy
D000894:Anti-Inflammatory Agents, Non-Steroidal