Non‐steroidal anti‐inflammatory drug prescriptions from the 6 th month of pregnancy: impact of advice from health authorities

Non‐steroidal anti‐inflammatory drugs ( NSAID s) are among the most widely used drugs. On June 2008 and February 2009, Dear Doctor Letters ( DDL s) were sent by the French Health Authorities ( AFSSAPS ) to remind practitioners of risks with NSAID s after the fifth month of pregnancy. The aim of this study was to evaluate the impact of these letters on NSAID prescriptions during late pregnancy. EFEMERIS is a French database that registers drugs prescribed and reimbursed during pregnancy and outcomes between 2004 and 2015. We performed a descriptive study and a ‘before‐and‐after’ comparison of NSAID prescriptions between 3 June 2006 and 3 June 2008 (‘before group’), and between 1 March 2010 and 1 March 2012 (‘after group’). We carried out a Cochran Armitage trend test to check whether the rate of women exposed to NSAID s varies linearly over time. We identified 948 (4.38%) pregnant women in the ‘before group’ and 678 (2.73%) in the ‘after group’ receiving at least one NSAID prescription in late pregnancy ( P  < 0.0001). Between 2006 and 2012, mainly prescriptions for morniflumate/niflumic acid (1.7% vs. 0.9%; P  < 0.0001), ibuprofen (0.8% vs. 0.6%; P  = 0.01) and ketoprofen (0.7% vs. 0.3%; P  < 0.0001) fell significantly after DDL s. The Cochran Armitage trend test shows that the percentage of women exposed to NSAID s in late pregnancy decreased significantly during the study period ( P  < 0.0001). This study highlighted a significant decrease in the percentage of women receiving NSAID prescriptions during late pregnancy after DDL s. This decrease is not linked to a specific women's profile or prescriber's medical discipline.