title: Trends and Determinants of Prescription Drug Use during Pregnancy and Postpartum in British Columbia, 2002-2011: A Population-Based Cohort Study.
abstract: OBJECTIVE
  To describe trends, patterns, and determinants of prescription drug use during pregnancy and postpartum.
  
  
  METHODS
  This is a retrospective, population-based study of all women who gave birth between January 2002 and 31 December 2011 in British Columbia, Canada. Study population consisted of 225,973 women who had 322,219 pregnancies. We examined administrative datasets containing person-specific information on filled prescriptions, hospitalizations, and medical services. Main outcome measures were filled prescriptions during pregnancy and postpartum. We used logistic regressions to examine associations between prescription drug use and maternal characteristics.
  
  
  RESULTS
  Approximately two thirds of women filled a prescription during pregnancy, increasing from 60% in 2002 to 66% in 2011. The proportion of pregnant women using medicines in all three trimesters of pregnancy increased from 20% in 2002 to 27% in 2011. Use of four or more different types of prescription drug during at least one trimester increased from 8.4% in 2002 to 11.7% in 2011. Higher BMI, smoking during pregnancy, age under 25, carrying multiples, and being diagnosed with a chronic condition all significantly increased the odds of prescription drug use during pregnancy.
  
  
  CONCLUSIONS
  The observed increase in the number of prescriptions and number of different drugs being dispensed suggests a trend in prescribing practices with potentially important implications for mothers, their neonates, and caregivers. Monitoring of prescribing practices and further research into the safety of most commonly prescribed medications is crucial in better understanding risks and benefits to the fetus and the mother.
authors.affiliation: Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Smolina
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Hanley
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mintzes
authors.affiliation: Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Tim F
authors.initials: TF
authors.lastname: Oberlander
authors.affiliation: Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Morgan
mesh_terms: D000328:Adult; D001955:British Columbia; D016208:Databases, Factual; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D055553:Prescription Drugs / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D055553:Prescription Drugs