Trends in antihypertensive prescription for pregnant women with hypertension and their peripartum outcomes before and after label and guideline revisions in Japan.
Female
Humans
Infant, Newborn
Pregnancy
Antihypertensive Agents
Methyldopa
/ therapeutic use
Nifedipine
Pregnant Women
Peripartum Period
Cesarean Section
Retrospective Studies
Japan
Premature Birth
/ chemically induced
Hypertension
/ drug therapy
Hydralazine
/ therapeutic use
Drug Prescriptions
Pregnancy Outcome
Antihypertensives
Claims database
Hypertensive disorders of pregnancy
Regulatory action
Journal
Hypertension research : official journal of the Japanese Society of Hypertension
ISSN: 1348-4214
Titre abrégé: Hypertens Res
Pays: England
ID NLM: 9307690
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
17
04
2022
accepted:
13
08
2022
revised:
20
07
2022
pubmed:
16
9
2022
medline:
9
11
2022
entrez:
15
9
2022
Statut:
ppublish
Résumé
We investigated the trends in the proportion of antihypertensive prescriptions listed in the guidelines for pregnant patients and their pregnancy outcomes before and after regulatory actions in Japan. This retrospective cohort study used the Japan Medical Data Center claims data from January 2005 to April 2020. We identified women who had delivered and had hypertensive disorders before childbirth. To evaluate the influence of regulatory actions (label revision in 2011 and guideline updates in 2014), we divided the study period into three terms based on the year of the last menstrual period. We assessed the time trend of the prescription proportion of antihypertensives and conducted multivariable logistic regression analyses to assess the impact of the investigation terms on pregnancy outcomes (preterm birth, cesarean section, emergency cesarean section, and Hemolysis, Elevated Liver enzymes, and Low Platelets syndrome). Among the 13,797 eligible patients, 1739 (12.6%) were treated with oral antihypertensives during pregnancy. Before the policy revisions, the most frequently prescribed antihypertensive medication was methyldopa, but after the label and guideline revisions, nifedipine was the most frequently prescribed. The trend in the prescription proportion of nifedipine increased (P < 0.001) and that of hydralazine decreased (P < 0.001), while those of methyldopa and labetalol showed no significant trend. The adjusted odds ratios for all four pregnancy outcomes showed no significant differences according to the investigation terms. By investigating the three terms before and after the label and guideline revisions, significant changes were identified in the trend of the prescription proportion for pregnant women-an increase in nifedipine and a decrease in hydralazine-but not in pregnancy outcomes.
Identifiants
pubmed: 36109600
doi: 10.1038/s41440-022-01018-8
pii: 10.1038/s41440-022-01018-8
doi:
Substances chimiques
Antihypertensive Agents
0
Methyldopa
56LH93261Y
Nifedipine
I9ZF7L6G2L
Hydralazine
26NAK24LS8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1823-1831Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. The Author(s), under exclusive licence to The Japanese Society of Hypertension.
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