title: Prescription of asthma medications before and during pregnancy in France: An observational drug study using the EFEMERIS database.
abstract: OBJECTIVE
  Asthma affects between 3% to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medications change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France.
  
  
  METHODS
  Women from the EFEMERIS, a French database assessing the drugs prescribed, dispensed and reimbursed during pregnancy, delivering between July 2004 and December 2012, were included. Women, who were dispensed asthma medications on at least two dates from 3 months prior to pregnancy through delivery, were considered.
  
  
  RESULTS
  2,977 women out of 69,205 (4%) were selected. They were prescribed 2.4 ± 1.2 different anti-asthmatic drugs with 3.5 ± 2.7 different dispensing dates. Almost 62% of the women were dispensed at least one prescription for short-acting β2-agonist (SABA), 63% at least one inhaled corticosteroid (IC), 42% a fixed-combination of an IC and a long-acting β2-agonist (LABA) and 8% a LABA. An increase in SABA and IC prescriptions and a decrease in fixed-combination prescriptions were observed during pregnancy compared to pre-pregnancy period. A rapid drop in prescriptions for montelukast was observed. Among the 1,507 women who were prescribed asthma medication before pregnancy, one third had a drop in dispensed asthma medications from the beginning of pregnancy.
  
  
  CONCLUSIONS
  The prevalence of dispensed asthma medications varies during pregnancy. There is a decrease in the prescriptions of fixed-combinations during pregnancy and an increase in the prescriptions of ICs. It appears important to study the potential impact of such changes on fetuses and newborns.
authors.affiliation: a Service de Pharmacologie Médicale et Clinique, CHU Toulouse, Pharmacopôle Midi-Pyrénées, Faculté de Médecine, INSERM , Toulouse , France.
authors.forename: Anna-Belle
authors.initials: AB
authors.lastname: Beau
authors.affiliation: b Service de Pneumologie, Pôle des Voies Respiratoires, Hôpital Larrey, CHU Toulouse , France.
authors.forename: Alain
authors.initials: A
authors.lastname: Didier
authors.affiliation: a Service de Pharmacologie Médicale et Clinique, CHU Toulouse, Pharmacopôle Midi-Pyrénées, Faculté de Médecine, INSERM , Toulouse , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hurault-Delarue
authors.affiliation: a Service de Pharmacologie Médicale et Clinique, CHU Toulouse, Pharmacopôle Midi-Pyrénées, Faculté de Médecine, INSERM , Toulouse , France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Montastruc
authors.affiliation: a Service de Pharmacologie Médicale et Clinique, CHU Toulouse, Pharmacopôle Midi-Pyrénées, Faculté de Médecine, INSERM , Toulouse , France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lacroix
authors.affiliation: a Service de Pharmacologie Médicale et Clinique, CHU Toulouse, Pharmacopôle Midi-Pyrénées, Faculté de Médecine, INSERM , Toulouse , France.
authors.forename: Christine
authors.initials: C
authors.lastname: Damase-Michel
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D016208:Databases, Factual / Q000706:statistics & numerical data*; D004338:Drug Combinations; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents; D004338:Drug Combinations
keywords: Asthma medication; EFEMERIS cohort; drug utilization study; pregnancy