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The Prevalence and Trends of Antiviral Medication Use During Pregnancy in the US: A Population-Based Study of 664,297 Deliveries in 2001–2007

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Abstract

To evaluate the prevalence, trends, timing and duration of exposure to antiviral medications during pregnancy within a US cohort of pregnant women and to evaluate the proportion of deliveries with a viral infection diagnosis among women given antiviral medication during pregnancy. Live-born deliveries between 2001 and 2007, to women aged 15–45 years, were included from the Medication Exposure in Pregnancy Risk Evaluation Program, a collaborative research program between the U.S. Food and Drug Administration and eleven health plans. They were evaluated for prevalence, timing, duration, and temporal trends of exposure to antiviral medications during pregnancy. We also calculated the proportion of deliveries with a viral infection diagnosis among those exposed to antiviral medications. Among 664,297 live births, the overall prevalence of antiviral exposure during pregnancy was 4 % (n = 25,155). Between 2001 and 2007, antiviral medication exposure during pregnancy doubled from 2.5 to 5 %. The most commonly used antiviral medication was acyclovir, with 3 % of the deliveries being exposed and most of the exposure occurring after the 1st trimester. Most deliveries exposed to antiviral medications were exposed for less than 30 days (2 % of all live births). Forty percent of the women delivering an infant exposed to antiviral medications had a herpes diagnosis. Our findings highlight the increased prevalence of women delivering an infant exposed to antiviral medications over time. These findings support the need for large, well-designed studies to assess the safety and effectiveness of these medications during pregnancy.

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Acknowledgments

Financial Support: Participation on this study by Lyndsay Avalos was funded by UCSF-Kaiser/DOR Building Interdisciplinary Research Careers in Women’s Health Program (K12HD052163, NICHD/NIH, Guglielmo, PI). Sascha Dublin was funded by grant K23AG028954 from the National Institute on Aging. This study was also supported through funding from contracts HHSF223200510012C, HHSF223200510009C, and HHSF223200510008C from the U.S. Food and Drug Administration (Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research).

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Correspondence to Lyndsay A. Avalos.

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The views expressed in this paper are those of the authors and are not intended to convey official US Food and Drug Administration (FDA) policy or guidance. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Appendices

Appendix 1

See Table 5.

Table 5 Dispensed prescriptions for FDA-approved antiviral medications during the study period and their FDA pregnancy category

Appendix 2

See Table 6.

Table 6 List of viral infections included in the study and ICD-9 codes

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Avalos, L.A., Chen, H., Yang, C. et al. The Prevalence and Trends of Antiviral Medication Use During Pregnancy in the US: A Population-Based Study of 664,297 Deliveries in 2001–2007. Matern Child Health J 18, 64–72 (2014). https://doi.org/10.1007/s10995-013-1234-9

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