Premium
Linking a pharmaceutical claims database with a birth defects registry to investigate birth defect rates of suspected teratogens
Author(s) -
Colvin Lyn,
SlackSmith Linda,
Stanley Fiona J.,
Bower Carol
Publication year - 2010
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1995
Subject(s) - medicine , pregnancy , pharmacovigilance , population , pharmacoepidemiology , medical prescription , record linkage , obstetrics , drugs in pregnancy , family medicine , adverse effect , environmental health , fetus , genetics , pharmacology , biology
Abstract Purpose Data linkage of population administrative data is being investigated as a tool for pharmacovigilance in pregnancy in Australia. Records of prescriptions of known or suspected teratogens dispensed to pregnant women have been linked to a birth defects registry to determine if defects associated with medicine exposure can be detected. Methods The Pharmaceutical Benefits Scheme is a national claims database that has been linked with population‐based data to extract linkages for women with a pregnancy event in Western Australia from 2002 to 2005 ( n = 106 074). Records of births to the women who were dispensed medicines in categories D or X of the Australian ADEC pregnancy risk category were linked to the Birth Defects Registry of Western Australia. Population rates of registered birth defects per 1000 births were calculated for each medicine. Results There were 47 medicines dispensed at least once during pregnancy with 23 associated with a registered birth defect to a woman dispensed the medicine. When the birth defect rate for each medicine was compared with the rate for all other women not dispensed that medicine, most medicines showed an increased risk. Medicines with the higher risks were medroxyprogesterone acetate (OR: 1.8; 95%CI: 1.4–2.3), follitropin alfa (OR: 2.5; 95%CI: 1.2–5.0), carbamazepine (OR: 3.1; 95%CI: 1.7–5.6) and enalapril maleate (OR: 8.1; 95%CI: 1.6–41.7). Conclusion Many known associations between medicines and birth defects were identified, suggesting that linked administrative data could be an important means of pharmacovigilance in pregnancy in Australia. Copyright © 2010 John Wiley & Sons, Ltd.