title: Dispensing of potentially teratogenic drugs before conception and during pregnancy: a population-based study.
abstract: OBJECTIVE
  To study the dispensing of potentially teratogenic drugs in the 12-month period before as well as during pregnancy in the Netherlands.
  
  
  METHODS
  Population-based study.
  
  
  METHODS
  A cohort was constructed using a linkage between the PHARMO Database Network and the Netherlands Perinatal Registry (PRN).
  
  
  METHODS
  A total of 203 962 Dutch pregnancies reported between 1999 and 2007 METHODS: Drug-dispensing information was identified from the PHARMO Database Network for the 12-month period before conception and during pregnancy. Drugs with either a Swedish FASS 'D' classification, an Australian ADEC or American FDA 'D' or 'X' classification were considered potentially teratogenic (n = 202).
  
  
  METHODS
  Proportion of pregnancies that received potentially teratogenic drugs in the 12-month period before and during pregnancy and specific for the risk category X drugs and newly initiated drugs.
  
  
  RESULTS
  Sixteen percent of the pregnancies received a potentially teratogenic drug in the 12-month period before and 5.07% during pregnancy. Doxycycline and paroxetine were most frequently received during pregnancy by 1.01% and 0.85% of women, respectively; 0.66% of the women received a risk category X drug during pregnancy which most frequently consisted of triptorelin (0.25%), norethisterone (0.22%) and simvastatin (0.03%). Fifty-three percent of the women who received a potentially teratogenic drug during pregnancy received this for the first time during the study period. These percentages were heterogeneous between therapeutic drug classes.
  
  
  CONCLUSIONS
  Five percent of the pregnancies received a potentially teratogenic drug during pregnancy and 0.66% received a drug from the risk category X. It may be possible to reduce these proportions when reasons for prescription have been explored.
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands.|Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.|Dutch Medicines Evaluation Board, Utrecht, the Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: Zomerdijk
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Ruiter
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: L M A
authors.initials: LM
authors.lastname: Houweling
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: R M C
authors.initials: RM
authors.lastname: Herings
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands.
authors.forename: S M J M
authors.initials: SM
authors.lastname: Straus
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.|Drug Safety Unit, Inspectorate of Health Care, The Hague, the Netherlands.
authors.forename: B H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000328:Adult; D004318:Doxycycline / Q000008:administration & dosage; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009640:Norethindrone / Q000008:administration & dosage; D017374:Paroxetine / Q000008:administration & dosage; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D019821:Simvastatin / Q000008:administration & dosage; D013723:Teratogens / Q000600:supply & distribution*; D013997:Time Factors; D017329:Triptorelin Pamoate / Q000008:administration & dosage
chemical_list: D013723:Teratogens; D017329:Triptorelin Pamoate; D017374:Paroxetine; D019821:Simvastatin; D004318:Doxycycline; D009640:Norethindrone
keywords: Drug safety; embryotoxic; maternal drug use; pregnancy; teratogens