Title

Prevalence, Trends, and Patterns of Use of Antidiabetic Medications Among Pregnant Women, 2001-2007

UMMS Affiliation

Meyers Primary Care Institute

Date

1-1-2013

Document Type

Article

Medical Subject Headings

Diabetes Mellitus; Diabetes, Gestational; Pregnancy in Diabetics; Hypoglycemic Agents

Disciplines

Endocrine System Diseases | Maternal and Child Health | Nutritional and Metabolic Diseases | Obstetrics and Gynecology | Pharmaceutical Preparations

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.

LEVEL OF EVIDENCE: III.

Comments

Citation: Obstet Gynecol. 2013 Jan;121(1):106-114. DOI: 10.1097/AOG.0b013e318278ce86

Related Resources

Link to article in PubMed

PubMed ID

23262934