title: Prevalence, trends, and patterns of use of antidiabetic medications among pregnant women, 2001-2007.
abstract: OBJECTIVE
  To describe the prevalence, trends, and patterns in use of antidiabetic medications to treat hyperglycemia and insulin resistance before and during pregnancy in a large U.S. cohort of insured pregnant women.
  
  
  METHODS
  Pregnancies resulting in live births were identified (N=437,950) from 2001 to 2007 among 372,543 females 12-50 years of age at delivery from 10 health maintenance organizations participating in the Medication Exposure in Pregnancy Risk Evaluation Program. Information for these descriptive analyses, including all antidiabetic medications dispensed during this period, was extracted from electronic health records and newborn birth certificates.
  
  
  RESULTS
  A little more than 1% (1.21%) of deliveries were to women dispensed antidiabetic medication in the 120 days before pregnancy. Use of antidiabetic medications before pregnancy increased from 0.66% of deliveries in 2001 to 1.66% of deliveries in 2007 (P<.001) because of an increase in metformin use. Most women using metformin before pregnancy had a diagnosis code for polycystic ovaries or female infertility (67.2%), whereas only 13.6% had a diagnosis code for diabetes. The use of antidiabetic medications during the second or third trimester of pregnancy increased from 2.8% of deliveries in 2001 to 3.6% in 2007 (P<.001). Approximately two thirds (68%) of women using metformin before pregnancy did not use any antidiabetic medications during pregnancy.
  
  
  CONCLUSIONS
  Antidiabetic medication use before and during pregnancy increased from 2001 to 2007, possibly because of increasing prevalence of gestational diabetes mellitus, type 1 and type 2 diabetes, and other conditions associated with insulin resistance.
  
  
  METHODS
  III.
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California 91101, USA. Jean.M.Lawrence@kp.org
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: Susan E
authors.initials: SE
authors.lastname: Andrade
authors.forename: Lyndsay A
authors.initials: LA
authors.lastname: Avalos
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Beaton
authors.forename: Vicki Y
authors.initials: VY
authors.lastname: Chiu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Davis
authors.forename: Sascha
authors.initials: S
authors.lastname: Dublin
authors.forename: Pamala A
authors.initials: PA
authors.lastname: Pawloski
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Raebel
authors.forename: David H
authors.initials: DH
authors.lastname: Smith
authors.forename: Sengwee
authors.initials: S
authors.lastname: Toh
authors.forename: Jean Q
authors.initials: JQ
authors.lastname: Wang
authors.forename: Sigal
authors.initials: S
authors.lastname: Kaplan
authors.forename: Thushi
authors.initials: T
authors.lastname: Amini
authors.forename: Christian
authors.initials: C
authors.lastname: Hampp
authors.forename: Tarek A
authors.initials: TA
authors.lastname: Hammad
authors.forename: Pamela E
authors.initials: PE
authors.lastname: Scott
authors.forename: T Craig
authors.initials: TC
authors.lastname: Cheetham
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007231:Infant, Newborn; D007247:Infertility, Female / Q000175:diagnosis; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D014481:United States; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin