Key Findings: New CDC Study Provides Basis for Future Research on Medication Use During Pregnancy

Health insurance claims (records from hospital, doctor, and pharmacy visits) can be a rich data source to look at many types of health information, but pregnant women are not always easy to identify in these data. In a study published in the journal Birth Defects Research (Part A), CDC researchers developed a method to identify pregnant women in health insurance databases, and find important information about their pregnancies and their use of antidepressants during pregnancy. Researchers identified nearly 490,000 pregnancies in 2013 health insurance claims data, and found that one in 16 pregnant women filled a prescription for an antidepressant during pregnancy. This study will help future efforts to estimate the use of other medications before and during pregnancy using health insurance claims data. Read the scientific summary of the study.

Main Findings

• Using health insurance claims data, researchers identified nearly 490,000 pregnancies in 2013.
• For every one in 16 pregnancies (6.2%), an antidepressant prescription was filled.
• The number of prescriptions filled for an antidepressant was lowest during the second trimester of pregnancy.
• Selective serotonin reuptake inhibitors (SSRIs) were the most commonly filled type of antidepressant.
  • Among SSRIs, sertraline was the most commonly filled medication.
• This research is an important first step for for future work that will look at the use of many different types of medications before and during pregnancy.

About the Study

• There is little information about medication use among pregnant women. Health insurance claims data provide a unique opportunity to look at medication use during pregnancy, such as prescriptions filled for antidepressant medications.
• Researchers used Truven Health MarketScan® Commercial Claims and Encounters Databases for their study. This is a large sample of individuals with mainly employer-sponsored private insurance. These databases include inpatient and outpatient services, outpatient pharmacy prescription claims, and healthcare plan annual enrollment information.
• The researchers created an algorithm, or a predetermined set of rules, which was used to identify health insurance claims for pregnant women in the databases, when the women became pregnant, and the outcomes (for example, live birth or pregnancy loss) of their pregnancies.

Medication Use During Pregnancy: CDC’s Activities

CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) works to improve the health of women and babies. Through its Treating for Two: Safer Medication Use in Pregnancy initiative, CDC works with partners, other federal agencies, and the public to

• Understand trends in medication use among pregnant women and women of reproductive age; and
• Provide women and healthcare providers with information about the safety or risk of using specific medications during pregnancy.

This information will help women and their healthcare providers to make informed decisions about treating health conditions during pregnancy.

Treating for Two focuses on the following activities:

• Better research: Expanding and accelerating research to fill gaps in knowledge about medication use before and during pregnancy.
• Informed decisions: Delivering up-to-date information to support decision-making among prescribers of medications, pharmacists, and the public.
• Reliable guidance: Evaluating scientific evidence to provide reliable guidance.

Pregnant women should not stop or start taking any medications without first talking with a healthcare provider. Women who are planning to become pregnant should discuss the need for any medication with their healthcare provider and ensure that they are taking only medications that are necessary.

More Information

• For more information about medications and pregnancy, visit https://www.cdc.gov/pregnancy/meds or www.cdc.gov/treatingfortwo.
• Have questions about how medications you are taking may affect a pregnancy? MotherToBaby.org can help you find the answers to your questions.

Key Findings Reference

Ailes EC, Simeone RM, Dawson AL, Petersen EE, Gilboa SM. Using insurance claims data to identify and estimate critical periods in pregnancy: An application to antidepressants. Birth Defects Research Part A: Clinical and Molecular Teratology. 2016 Nov 1; 106(11):927-34.

Additional References

1. Centers for Disease Control and Prevention. Update on overall prevalence of major birth defects—Atlanta, Georgia, 1978-2005. MMWR Morb Mortal Wkly Rep. 2008;57(1):1-5.
2. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet Part C Semin Med Genet. 2011;157:175-82.