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European Journal of Epidemiology

, Volume 28, Issue 9, pp 759–769 | Cite as

Triptan safety during pregnancy: a Norwegian population registry study

  • Kateřina Nezvalová-HenriksenEmail author
  • Olav Spigset
  • Hedvig Nordeng
PHARMACO-EPIDEMIOLOGY

Abstract

Knowledge on triptan safety during pregnancy remains limited to their class effect or studies on sumatriptan. Our aim was to evaluate the individual effect of four most frequently used triptans on several pregnancy outcomes. We used the Norwegian prescription database to access information on triptans redeemed by pregnant women living in Norway between 2004 and 2007. This database was linked to the Medical Birth Registry of Norway covering every institutional delivery in Norway and providing information on pregnancy, delivery, maternal and neonatal health. Estimates of associations with pregnancy outcomes were obtained by Generalised Estimation Equations analysis. Of the 181,125 women in our study, 1,465 (0.8 %) redeemed triptans during pregnancy, and 1,095 (0.6 %) redeemed triptans before pregnancy only (disease comparison group). The population comparison group comprised the remaining 178,565 women. Using this group as reference, we found no associations between triptan redemption during pregnancy and congenital malformations. Second trimester redemption was associated with postpartum haemorrhage (adjusted OR 1.57; 95 % CI 1.19–2.07). The disease comparison group had an increased risk of major congenital malformations (adjusted OR 1.48; 95 % CI 1.11–1.97), low birth weight (adjusted OR 1.39; 95 % CI 1.08–1.81), and preterm birth (adjusted OR 1.30; 95 % CI 1.06–1.60). The association of triptans with postpartum hemorrhage could be attributable to decreased platelet agreeability occurring in severe migraine. Likewise, the increased risk of major congenital malformations and other adverse pregnancy outcomes in the disease comparison group might be attributable to migraine severity.

Keywords

Triptans Migraine Pregnancy Congenital malformations Adverse pregnancy outcomes 

Supplementary material

10654_2013_9831_MOESM1_ESM.pdf (97 kb)
Supplementary material 1 (PDF 98 kb)

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Kateřina Nezvalová-Henriksen
    • 1
    Email author
  • Olav Spigset
    • 2
    • 3
  • Hedvig Nordeng
    • 1
    • 4
  1. 1.Department of Pharmacy, School of Pharmacy, Faculty of Mathematics and Natural SciencesUniversity of OsloOsloNorway
  2. 2.Department of Clinical PharmacologySt Olav’s University HospitalTrondheimNorway
  3. 3.Department of Laboratory Medicine, Children’s and Women’s HealthNorwegian University of Science and TechnologyTrondheimNorway
  4. 4.Division of Mental HealthThe Norwegian Institute of Public HealthOsloNorway

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