Uses of Antiepileptic Drugs Among Pregnant Women with Epilepsy in Taiwan, a 15-Year Cohort Study
Author(s)
Lin YC1, Lin CW2, Huang WI2, Chen WW2, Hsiao FYS1
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, TPQ, Taiwan, 2Taiwan Drug Relief Foundation, Taipei, Taiwan
Presentation Documents
Introduction: Seizure control is important in pregnant women with epilepsy, but the potential adverse obstetric effects associated with antiepileptic drugs (AEDs) have raised significant concern. A better understanding regarding uses of AEDs among pregnant women with epilepsy is therefore essential to justify the benefits and risks of its use among this population. The aim of this nationwide study was to assess the uses of AEDs in pregnant women with epilepsy in Taiwan from 2004 to 2018. Method: This study used data retrieved from two national databases, the Birth Certificate Registry and Taiwan National Health Insurance Research Dataset (NHIRD). In the first part, AEDs (phenytoin, carbamazepine, oxcarbazepine, valproic acid, lamotrigine, topiramate, levetiracetam and others) used among pregnant women were assessed annually from 2004 to 2018. In the second part, for each study subject, we assessed their use of AEDs in -360~-270 days, -269~-180 days, -179~-90 days, -89~0 days prior to pregnancy and first-, second-, and third- trimesters to capture the potential time-varying changes of AEDs before and during pregnancy. Results: Among 2,883,200 pregnant women, 28,655 (0.99%) received at least one AEDs prescription 1 year prior to pregnancy, and 3,652 (0.13%) received AEDs for epilepsy. From 2004 to 2018, use of carbamazepine (66.0% to 16.9%), valproic acid (24.8% to 7.2%) and phenytoin (21.6% to 2.9%) among pregnant women decreased while lamotrigine (13.1% to 39.1%), levetiracetam (0% to 48.3%) and oxcarbazepine (3.3% to 19.8%) increased. For AEDs use before and during the pregnancy, we found that approximately 75% of women with epilepsy used AEDs prior to pregnancy. However, the proportion of women who used AEDs declined subsequently in the first- (66.5%), second- (61.9%), and third- (60.2%) trimesters of pregnancy. Conclusion: Our study provides “real-world data” of uses of AEDs in pregnant women with epilepsy in Taiwan from 2004 to 2018.
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Code
EPH71
Topic
Epidemiology & Public Health, Real World Data & Information Systems, Study Approaches
Topic Subcategory
Health & Insurance Records Systems, Safety & Pharmacoepidemiology
Disease
Drugs, Reproductive and Sexual Health