Use of Prescribed Drugs to Treat Chronic Diseases during Pregnancy in Outpatient Care in Switzerland between 2014 and 2018: Descriptive Analysis of Swiss Health Care Claims Data
Abstract
:1. Introduction
2. Methods
2.1. Data Source
2.2. Pregnancy Cohort
2.2.1. Identification of Pregnancies and Delivery Date
2.2.2. Estimation of the Date of the Last Menstrual Period and Pregnancy Trimesters
2.3. Demographics and Characteristics
Exposure to Drugs
2.4. Statistical Analyses
2.5. Protocol Approvals
3. Results
Year | N of Weighted Deliveries in Our Study Population | Weighted Age at Delivery in the Cohort (Weighted sd) | Age at Delivery in Switzerland (BfS) | Weighted Percentage of Caesarean Section in the Cohort (%, 95% CI) | Percentage of Caesarean Section in Switzerland (BfS) |
---|---|---|---|---|---|
2014 | 71,933 | 31.96 (5.04) | 31.7 | 34.4 (33.4, 35.5) | 33.7 |
2015 | 71,844 | 31.97 (5.15) | 31.8 | 34.3 (33.3, 35.4) | 33.3 |
2016 | 74,149 | 31.93 (5.11) | 31.8 | 33.4 (32.4, 34.5) | 33.2 |
2017 | 79,610 | 32.06 (5.14) | 31.9 | 33.4 (32.4, 34.6) | 32.3 |
2018 | 71,836 | 32.15 (5.00) | 32.0 | 33.1 (32.0, 34.2) | 32.1 |
3.1. Prevalence of Drug Exposure
ATC Code | Drug Substance | Pre-Pregnancy N (/10,000) | 95% CI | T1 N (/10,000) | 95% CI | T2 N (/10,000) | 95% CI | T3 N (/10,000) | 95% CI | T1–T3 N (/10,000) | 95% CI |
---|---|---|---|---|---|---|---|---|---|---|---|
At least one drug from any of the following drug groups | 43,179 (1169.0) | 1136.0–1202.0 | 39,978 (1008.6) | 1050.4–1114.3 | 41,601 (1126.3) | 1093.8–1158.7 | 57,980 (1569.7) | 1531.5–1607.9 | 81,715 (2212.3) | 2168.4–2256.1 | |
H03 | Thyroid therapy | 10,581 (286.5) | 270.1–302.9 | 17,570 (475.7) | 454.3–497.0 | 19,111 (517.4) | 495.3–539.5 | 17,677 (478.6) | 457.3–499.8 | 24,874 (673.4) | 648.3–698.5 |
H03A | Thyroid preparations | 10,223 (276.8) | 260.6–292.9 | 17,206 (465.8) | 444.7–486.9 | 18,834 (509.9) | 488–531.8 | 17,470 (473) | 451.8–494.1 | 24,418 (661.1) | 636.2–686 |
H03AA01 | Levothyroxine sodium | 10,087 (273.1) | 257.1–289.1 | 17,081 (462.4)) | 441.4–483.4 | 18,690(506) | 484.2–527.8 | 17,365 (470.1) | 449–491.2 | 24,228 (655.9) | 631.2–680.7 |
H03AA02 | Liothyronine sodium | 0.0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 |
H03B | Antithyroid preparations | 388 (10.5) | 7.4–13.6 | 378 (10.2) | 7.2–13.3 | 284 (7.7) | 5–10.4 | 207 (5.6) | 3.4–7.8 | 491 (13.3) | 9.7–16.9 |
H03BA02 | Propylthiouracil | 174 (4.7) | 2.6–6.8 | 285 (7.7) | 5–10.5 | 137 (3.7) | 1.8–5.6 | 88 (2.4) | 0.9–3.8 | 328 (8.9) | 5.9–11.8 |
H03BB01 | Carbimazole | 255 (6.9) | 4.3–9.5 | 174 (4.7) | 2.7–6.7 | 164 (4.4) | 2.4–6.5 | 126 (3.4) | 1.7–5.1 | 311 (8.4) | 5.6–11.2 |
C02, C03, C07, C08, C09 | Anti-hypertensive drugs | 2612 (70.7) | 62.2–79.2 | 2290 (62) | 53.9–70.1 | 4716 (127.7) | 116.3–139 | 17,177 (465) | 443.5–486.6 | 19,594 (530.5) | 507.6–553.3 |
C08 | Calcium channel blockers | 279 (7.6) | 4.7–10.4 | 405 (11) | 7.9–14.1 | 2917 (79) | 70.2–87.7 | 14,585 (394.9) | 375.2–414.5 | 15,778 (427.2) | 406.8–447.5 |
C08CA05 | Nifedipine | 157 (4.3) | 2.1–6.4 | 289 (7.8) | 5.2–10.5 | 2827 (76.5) | 67.9–85.1 | 14,423 (390.5) | 371–410 | 15,531 (420.5) | 400.3–440.7 |
C08CA01 | Amlodipine | 94 (2.5) | 0.8–4.3 | 106 (2.9) | 1.2–4.5 | 85 (2.3) | 0.7–3.9 | 154 (4.2) | 2–6.3 | 233 (6.3) | 3.7–8.9 |
C07 | Beta-blocking agents | 1651 (44.7) | 37.9–51.5 | 1847 (50) | 42.6–57.4 | 1860 (50.4) | 43–57.8 | 2878 (77.9) | 68.6–87.3 | 4193 (113.5) | 102.4–124.6 |
C07AG01 | Labetalol | 225 (6.1) | 3.7–8.5 | 670 (18.1) | 13.3–23 | 987 (26.7) | 20.8–32.6 | 2019 (54.7) | 46.5–62.8 | 2484 (67.2) | 58.2–76.3 |
C07AB02 | Metoprolol | 555 (15) | 11.2–18.9 | 640 (17.3) | 13.3–21.3 | 520 (14.1) | 10.7–17.5 | 521 (14.1) | 10.6–17.6 | 986 (26.7) | 21.8–31.6 |
C09 | RAA acting agents | 610 (16.5) | 12.3–20.7 | 227 (6.1) | 3.7–8.6 | 105 (2.8) | 1.1–4.5 | 72 (1.9) | 0.6–3.2 | 341 (9.2) | 6.3–12.2 |
C09CA06 | Candesartan | 59 (1.6) | 0.4–2.8 | 54 (1.5) | 0.3–2.6 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 54 (1.5) | 0.3–2.6 |
C09AA03 | Lisinopril | 87 (2.4) | 0.9–3.8 | 46 (1.2) | 0.0–2.5 | 30 (0.8) | 0.0–1.8 | 13 (0.4) | 0.0–0.9 | 58 (1.6) | 0.2–2.9 |
C03 | Diuretics | 277 (7.5) | 4.7–10.3 | 105 (2.8) | 1.1–4.6 | 59 (1.6) | 0.4–2.8 | 126 (3.4) | 1.7–5.1 | 271 (7.3) | 4.6–10 |
C03CA01 | Furosemide | 77 (2.1) | 0.7–3.5 | 18 (0.5) | 0.0–1.0 | 27 (0.7) | 0.0–1.6 | 95 (2.6) | 1.0–4.1 | 139 (3.8) | 1.9–5.6 |
C03CA04 | Torasemide | 94 (2.5) | 0.6–4.4 | 58 (1.6) | 0.1–3.1 | 32 (0.9) | 0.0–1.8 | 31 (0.8) | 0.1–1.6 | 115 (3.1) | 1.2–5.0 |
C02 | Antihypertensives | 58 (1.6)) | 0.3–2.9 | 17 (0.5) | 0.0–1.4 | 17 (0.5) | 0.0–1.4 | 24 (0.6) | 0.0–1.6 | 24 (0.6) | 0.0–1.6 |
C02AB01 | Methyldopa | 0 (0.0) | 0.0–0.0 | 17 (0.5) | 0.0–1.4 | 17 (0.5) | 0.0–1.4 | 25 (0.6) | 0.0–1.6 | 24 (0.6) | 0.0–1.6 |
C02CA04 | Doxazosin | 0 (0.0) | 0.0–0.0 | 17 (0.5) | 0.0–1.4 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 17 (0.5) | 0.0–1.4 |
N06A, N05A, N05AN, N05BA, N05CD, N05CF | Psychotropic drugs | 15,794 (427.6) | 407.2–448 | 9222 (249.7) | 234.1–265.2 | 6468 (175.1) | 162.2–188 | 6236 (168.8) | 156.3–181.4 | 14,084 (381.3) | 362.2–400.4 |
N06A | Antidepressants | 9442 (255.6) | 239.9–271.3 | 6488 (175.6) | 162.7–188.6 | 4572 (123.8) | 112.9–134.6 | 3940 (106.7) | 96.9–116.4 | 9150 (247.7) | 232.4–263 |
N06AB | Selective serotonin reuptake inhibitors | 5632 (152.5) | 140.4–164.6 | 4143 (112.2) | 101.7–122.6 | 3263 (88.3) | 79.1–97.6 | 2831 (76.6) | 68.3–85 | 5952 (161.1) | 148.6–173.7 |
N06AB10 | Escitalopram | 2313 (62.6) | 54.9–70.3 | 1422 (38.5) | 32.4–44.6 | 972 (26.3) | 21.5–31.1 | 912 (24.7) | 20–29.4 | 2054 (55.6) | 48.4–62.8 |
N06AB06 | Sertraline | 1324 (35.8) | 30.0–41.7 | 1093 (29.6) | 24–35.1 | 1148 (31.1) | 25.5–36.7 | 1075 (29.1) | 23.9–34.3 | 1817 (49.2) | 42.2–56.2 |
N06AX | Other antidepressants | 3871 (104.8) | 94.8–114.8 | 2353 (63.7) | 56.1–71.3 | 1344 (36.4) | 30.7–42 | 1092 (29.6) | 24.5–34.6 | 3360 (91) | 81.9–100.1 |
N06AX25 | Hyperici herba | 935 (104.8) | 20.2–30.4 | 609 (16.5) | 12.6–20.4 | 519 (14.1) | 10.5–17.6 | 487 (13.2) | 9.7–16.6 | 1291 (35) | 29.3–40.6 |
N06AX16, N06AX21 | Serotonin and noradrenaline reuptake inhibitors (duloxetine. venlafaxine) | 1155 (31.3) | 26–36.6 | 835 (22.6) | 18.2–27 | 433 (11.7) | 8.6–14.9 | 329 (8.9) | 6.1–11.7 | 946 (25.6) | 20.8–30.4 |
N06AX11, N06AX03 | Alpha antagonists (mirtazapine. mianserine) | 584 (15.8) | 12.0–14.3 | 370 (10.0) | 7.0–13.0 | 203 (5.5) | 3.2–7.8 | 122 (3.3) | 1.7–4.9 | 508 (13.8) | 10.2–17.3 |
N06AA | Non-selective monoamine reuptake inhibitors | 574 (15.5) | 11.6–19.4 | 396 (10.7) | 7.4–14.1 | 138 (3.7) | 1.8–5.6 | 137 (3.7) | 1.9–5.5 | 506 (13.7) | 10–17.4 |
N06AA06 | Trimipramine | 321 (8.7) | 5.7–11.7 | 203 (5.5) | 3.1–7.9 | 53 (1.4) | 0.1–2.8 | 45 (1.2) | 0.0–2.4 | 238 (6.4) | 3.8–9.0 |
N06AA09 | Amitriptyline | 163 (4.4) | 2.3–6.5 | 113 (3.1) | 1.4–4.7 | 78 (2.1) | 0.9–3.4 | 92 (2.5) | 1.1–3.9 | 181 (4.9) | 2.8–7.0 |
N05A | Antipsychotics | 1881 (50.9) | 43.9–58.0 | 1099 (29.8) | 24.3–35.2 | 699 (18.9) | 14.8–23.1 | 761 (20.6) | 16.2–24.9 | 1424 (38.6) | 32.4–44.8 |
N05AH04 | Quetiapine | 749 (20.3) | 15.9–24.6 | 506 (13.7) | 10.2–17.2 | 433 (11.7) | 8.5–8.5 | 456 (12.3) | 9.0–15.6 | 650 (17.6) | 13.6–21.6 |
N05AX12 | Aripiprazole | 267 (7.2)) | 4.5–10 | 173 (4.7) | 2.5–6.9 | 108 (2.9) | 1.3–4.6 | 125 (3.4) | 1.6–5.2 | 251 (6.8) | 4.1–9.5 |
N05AH03 | Olanzapine | 177 (4.8) | 2.5–7.1 | 139 (3.8) | 1.5–6.0 | 49 (1.3) | 0.1–2.5 | 87 (2.4) | 0.9–3.8 | 190 (5.1) | 2.6–7.7 |
N05AX08 | Risperidone | 103 (2.8) | 1.2–4.4 | 47 (1.3) | 0.3–2.2 | 21 (0.6) | 0.0–1.2 | 18 (0.5) | 0.0–1.2 | 79 (2.1) | 0.8–3.4 |
N05AD01 | Haloperidol | 70 (1.9) | 0.6–3.2 | 62 (1.7) | 0.1–3.3 | 28 (0.8) | 0.0–1.6 | 23 (0.6) | 0.01.5 | 64 (1.7) | 0.9–4.7 |
N05AD08 | Droperidol | 390 (10.6) | 7.3–13.8 | 35 (0.9) | 0.1–1.8 | 12 (0.3) | 0.0–0.8 | 6 (0.2) | 0.0–0.5 | 53 (1.4) | 0.4–2.5 |
N05AF03 | Chlorprothixene | 81 (2.2) | 0.8–3.6 | 64 (1.7) | 0.4–3.1 | 29 (0.8) | 0.0–1.7 | 23 (0.6) | 0.0–1.5 | 104 (2.8) | 0.4–3.1 |
N05AN01 | Lithium | 17 (0.5) | 0.0–1.1 | 20 (0.5) | 0.0–1.1 | 10 (0.3) | 0.0–0.8 | 10 (0.3) | 0.0–0.8 | 29 (0.8) | 0.0–1.6 |
N05BA, N05CD, N05CF | Benzodiazepine derivatives/related drugs | 7509 (203.3) | 188.9–217.6 | 3492 (94.5) | 84.7–104.4 | 1926 (52.1) | 45–59.2 | 2180 (59) | 51.3–66.8 | 6141 (166.3) | 153.3–179.2 |
N05BA, N05CD | Benzodiazepine derivatives | 6260 (169.5) | 156.3–182.7 | 2656 (71.9) | 63.4–80.4 | 1642 (44.5) | 37.9–51 | 1749 (47.4) | 40.4–54.3 | 4958 (134.2) | 122.6–145.8 |
N05BA06 | Lorazepam | 2788 (75.5) | 66.7–84.3 | 1390 (37.6) | 31.4–43.9 | 853 (23.1) | 18.3–27.9 | 1034 (28) | 22.6–33.4 | 2813 (76.2) | 67.3–85.0 |
N05CD08 | Midazolam | 1963 (53.1) | 45.6–60.7 | 360 (9.7) | 6.8–12.7 | 68 (1.8) | 0.8–3.0 | 113 (3.1) | 1.2–4.9 | 514 (13.9) | 10.3–17.6 |
N05CF | Benzodiazepine related drugs | 1606 (43.5) | 37–50 | 989 (26.8) | 21.4–32.1 | 337 (9.1) | 6.1–12.0 | 517 (14) | 10.3–17.7 | 1486 (40.2) | 33.7–46.7 |
N05CF02 | Zolpidem | 1425 (38.6) | 32.5–44.7 | 908 (24.6)) | 19.5–29.6 | 333 (9) | 6.1–12.0 | 511 (13.8) | 10.1–17.5 | 1486 (40.2) | 31.6–44 |
N05CF01 | Zopiclone | 200 (5.4) | 2.9–7.9 | 87 (2.4) | 0.5–4.2 | 4 (0.1) | 0.0–0.3 | 6 (0.2) | 0.0–0.5 | 97 (2.6) | 0.7–4.5 |
A10 | Anti-diabetics | 3592 (97.2) | 87.6–106.9 | 3227 (87.4) | 78–96.8 | 4540 (122.9) | 112–133.9 | 12,659 (342.7) | 324.8–360.7 | 14,398 (389.8) | 370.7–408.9 |
A10A | Insulins and analogues | 1050 (28.4) | 23.2–33.7 | 1598 (43.3) | 36.7–49.8 | 4060 (109.9) | 99.7–120.2 | 12,258 (331.9) | 314.3–349.5 | 12,752 (345.2) | 327.3–363.2 |
A10AE | Long acting | 498 (13.5) | 9.8–17.2 | 866 (23.4) | 18.5–28.4 | 2434 (65.9) | 58.2–73.6 | 7328 (198.4) | 185.1–211.7 | 7903 (214) | 200.1227.8 |
A10AB | Fast acting | 922 (25) | 20.1–29.8 | 1281 (34.7) | 28.9–28.9 | 2104 (57) | 49.5–40.4 | 5812 (157.3) | 145.1–169.6 | 6085 (164.7) | 152.2–177.3 |
A10AC | Intermediate acting | 75 (2) | 0.6–3.5 | 203 (5.5) | 3.2–7.8 | 1027 (27.8) | 22.3–33.3 | 3688 (99.8) | 89.9–109.8 | 3978 (107.7) | 97.3–118.1 |
A10B | Blood glucose-lowering drugs | 2650 (71.7) | 63.5–80 | 1802 (48.8) | 41.7–55.9 | 595 (16.1) | 12–20.3 | 608 (16.5) | 12.1–20.8 | 2243 (60.7) | 52.8–68.6 |
A10BA02 | Metformin | 2483 (67.2) | 59.2–75.2 | 1726 (46.7) | 39.8–53.7 | 569 (15.4) | 11.3–19.5 | 541 (14.6) | 10.5–18.8 | 2086 (56.5) | 48.9–64.1 |
A10BJ02 | Liraglutide | 63 (1.7) | 0.5–2.9 | 32 (0.9) | 0.1–1.6 | 6 (0.2) | 0.0–0.5 | 18 (0.5) | 0.0–1.2 | 56 (1.5) | 0.4–2.6 |
A10BB01 | Glibenclamide | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 10 (0.3) | 0.0–0.8 | 36 () | 0.0–1.9 | 46 (1.2) | 0.2–2.4 |
R03 | Obstructive airway diseases | 7332 (198.5) | 184.6–212.3 | 5775 (156.3) | 143.9–168.7 | 6345 (171.8) | 158.9–184.7 | 6077 (164.5) | 151.9–177.2 | 13,414 (363.2) | 344.4381.9 |
R03AK | Adrenergics with glucocorticoids or other drugs (excl anticholinergics) | 5115 (138.5) | 126.9–150.1 | 3566 (96.5) | 86.7–106.4 | 3950 (106.9) | 96.7–117.1 | 3572 (96.7) | 86.8–106.6 | 7925 (214.6) | 200.1–229 |
R03AK07 | Formoterol and budesonide | 3396 (91.9) | 82.7–101.2 | 2219 (60.1) | 52.5–67.6 | 2618 (70.9) | 62.8–78.9 | 2242 (60.7) | 53.1–68.3 | 5337 (144.5) | 132.8–156.1 |
R03AK06 | Salmeterol and fluticasone | 1496 (40.5) | 33.9–47.1 | 1158 (31.4) | 25.5–37.2 | 1249 (33.8) | 27.7–39.9 | 1199 (32.5) | 26.4–38.5 | 2429 (65.8) | 57.3–74.2 |
R03AC | Selective B2 adrenoreceptor agonists | 2714 (73.5) | 64.9–82.1 | 2499 (67.7) | 59.4–75.9 | 2636 (71.4) | 63.1–79.6 | 2271 (61.5) | 53.8–69.2 | 5947 (161) | 148.3–173.7 |
R03AC02 | Salbutamol | 2362 (63.9) | 55.8–72.1 | 2132 (57.7) | 50.1–65.4 | 2297 (62.2) | 54.4–70 | 2046 (55.4) | 48–62.8 | 5289 (143.2) | 131.2–155.2 |
R03AC13 | Formoterol | 182 (4.9) | 3–6.9 | 244 (6.6) | 4.1–9.2 | 139 (3.8) | 2.1–5.5 | 123 (3.3) | 1.7–5.0 | 348 (9.4) | 6.4–12.5 |
R03BA | Inhaled Glucocorticoids | 596 (16.1) | 12.3–19.9 | 758 (20.5) | 16.1–24.9 | 899 (24.3) | 19.7–29.0 | 758 (20.5) | 16.2–24.8 | 2011 (54.4) | 47.3–61.6 |
R03BA02 | Budesonide | 227 (6.1) | 3.8–8.4 | 410 (11.1) | 7.8–14.4 | 479 (13) | 9.7–16.3 | 410 (11.1) | 8.0–14.2 | 1156 (31.3) | 26.0–36.6 |
R03BA05 | Fluticasone | 210 (5.7) | 3.3–8.1 | 191(5.2) | 2.9–7.4 | 269 (7.3) | 4.7–9.8 | 189 (5.1) | 3.1–7.1 | 514 (13.9) | 10.3–17.6 |
R03CC | Selective beta-2 adrenoreceptor agonists | 20 (0.5) | 0.0–1.2 | 12 (0.3) | 0.0–0.8 | 6 (0.2) | 0.0–0.5 | 412 (11.2) | 8.2–14.1 | 424 (11.5) | 8.4–14.5 |
R03CC05 | Hexoprenaline | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 395 (10.7) | 7.7–13.6 | 395 (10.7) | 7.7 |
R03CC02 | Salbutamol | 20 (0.5) | 0.0–1.2 | 12 (0.3) | 0.0–0.8 | 6 (0.2) | 0.0–0.5 | 17 (0.5) | 0.0–1.0 | 29 (0.8) | 0.1–1.5 |
R03BB | Anticholinergics | 198 (5.4) | 2.9–7.8 | 171 (4.6) | 2.5–6.8 | 165 (4.5) | 2.1–6.8 | 146 (4) | 2.0–5.9 | 394 (10.7) | 7.4–14.0 |
R03BB01 | Ipratropium bromide | 144 (3.9) | 1.8–6.0 | 136 (3.7) | 1.8–5.5 | 129 (3.5) | 1.5–5.5 | 127 (3.4) | 1.6–5.3 | 341 (9.2) | 6.2–12.3 |
R03BB04 | Tiotropium bromide | 27 (0.7) | 0.0–1.7 | 24 (0.6) | 0.0–1.4 | 13 (0.4) | 0.0–1.1 | 19 (0.5) | 0.0–1.3 | 43 (1.2) | 0.1–2.2 |
R03AL | Adrenergics in combination with anticholinergics | 120 (3.2) | 1.7–4.8 | 94 (2.5) | 1.0–4.1 | 108 (2.9) | 1.2–4.6 | 141 (3.8) | 2.1–5.5 | 305 (8.3) | 5.5–10.9 |
R03AL02 | Salbutamol and ipratropium bromide | 114 (3.1) | 1.5–4.7 | 89 (2.4) | 0.9–3.9 | 73 (2) | 0.7–3.2 | 124 (3.4) | 1.8–4.9 | 259 (7) | 4.6–9.4 |
R03DC (R03DC03) | Leukotriene receptor antagonists (Montelukast) | 339 (9.2) | 6.2–12.2 | 214 (5.8) | 3.5–8.1 | 105 (2.8) | 1.1–4.5 | 51 (1.4) | 0.2–2.5 | 278 (7.5) | 4.8–10.2 |
R03DX | Other systemic drugs for obstructive airway diseases | 99 (2.7) | 1.0–4.3 | 69 (1.9) | 0.4–3.3 | 13 (0.4) | 0.0–1.0 | 27 (0.7) | 0.0–1.7 | 69 (1.9) | 0.4–3.3 |
R03DX05 | Omalizumab | 80 (2.2) | 0.7–3.6 | 49 (1.3) | 0.1–2.5 | 13 (0.4) | 0.0–1.0 | 27 (0.7) | 0.0–1.7 | 49 (1.3) | 0.1–2.5 |
R03DX09 | Mepolizumab | 19 (0.5) | 0.0–1.3 | 19 (0.5) | 0.0–1.3 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 19 (0.5) | 0.0–1.3 |
H02AB, A07EC, P01BA02, L03, L04AD, AX, AA, J06BA | Drugs to treat auto-immune diseases | 8560 (231.7) | 216.9–246.6 | 5104 (138.2) | 126.8–149.6 | 3414 (92.4) | 83.1–101.7 | 4593 (124.3) | 113.3–135.4 | 9947 (269.3) | 253.2–285–4 |
H02AB | Systemic glucocorticoids | 6831 (184.9) | 171.7–198.2 | 3673 (99.4) | 89.7–109.2 | 2309 (62.5) | 54.9–70.1 | 3375 (91.4) | 81.9–100.9 | 8237 (223) | 208.3–237.7 |
L04AD, AX, AA, A07EC, P01BA02, L01XC02 | Traditional immunosuppressants | 1647 (44.6) | 38.1–51.0 | 1466 (39.7) | 33.6–45.8 | 1295 (35.1) | 29.3–40.8 | 1338 (36.2) | 30.4–42.0 | 1951 (52.8) | 45.8–59.9 |
A07EC02 | Mesalazine | 549 (44.6)) | 11.1–18.6 | 541 (14.6) | 10.9–18.4 | 552 (14.9) | 11.2–18.7 | 623 (16.9) | 12.9–20.9 | 845 (22.9) | 18.2–27.5 |
A07EC01 | Sulfasalazine | 197 (5.3) | 3.0–7.6 | 187 (5.1) | 2.8–7.3 | 146 (4) | 2.1–5.8 | 128 (3.5) | 1.7–5.2 | 203 (5.5) | 3.2–7.8 |
P01BA02 | Hydroxychloroquine | 324 (8.8) | 6.1–11.5 | 320 (8.7) | 5.9–11.4 | 300 (8.1) | 5.4–10.8 | 333 (9) | 6.1–11.9 | 404 (10.9) | 7.8–14.1 |
L04AX0 | Azathioprine | 490 (13.3) | 9.6–17.0 | 384 (10.4) | 7.3–13.5 | 376 (10.2) | 6.9–13.5 | 345 (9.3) | 6.4–12.3 | 484 (13.1) | 9.4–16.8 |
L04AD02 | Tacrolimus | 41 (1.1) | 0.1–2.1 | 38 (1) | 0.1–1.9 | 47 (1.3) | 0.2–2.3 | 47 (1.3) | 0.2–2.3 | 47 (1.3) | 0.2–2.3 |
L04AD01 | Ciclosporin | 6 (0.2) | 0.0–0.5 | 9 (0.2) | 0.0–0.7 | 0 (0.0) | 0.0–0.0 | 13 (0.4) | 0.0–0.8 | 21 (0.6) | 0.0–1.2 |
L04AX03, L01BA01 | Methotrexate | 70 (1.9) | 0.5–3.3 | 13 (0.4) | 0.0–1.0 | 0 (0.0) | 0.0–0.0 | 11 (0.3) | 0.0–0.7 | 24 (0.6) | 0.0–1.4 |
L04AX03 | Methotrexate (low dose) | 20 (0.5) | 0.0–1.3 | 13 (0.4) | 0.0–1.0 | 0 (0.0) | 0.0–0.0 | 11 (0.3) | 0.0–0.7 | 24 (0.6) | 0.0–1.4 |
L01BA01 | Methotrexate (high dose) | 51 (1.4) | 0.2–2.5 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 |
L04AA06 | Myophenolic acid | 11 (0.3) | 0.0–0.8 | 11 (0.3) | 0.0–0.8 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 11 (0.3) | 0.0–0.9 |
L04AA29 | Tofacitinib | 8 (0.2) | 0.0–0.6 | 20 (0.5) | 0.0–1.3 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 20 (0.5) | 0.0–1.3 |
L04AB, AC | Biologic DMARDS | 821 (22.2) | 17.5–27 | 682 (18.5) | 14.3–22.7 | 438 (11.9) | 8.6–15.1 | 316 (8.6) | 5.7–11.4 | 725 (19.6) | 15.3–24.0 |
L04AB | TNF-alpha inhibitors | 764 (20.7) | 16.1–25.3 | 661 (17.9) | 13.8–22.0 | 430 (11.6) | 8.4–14.9 | 316 (8.6) | 5.7–11.4 | 704 (19.1) | 14.8–23.3 |
L04AB05 | Certolizumab | 143 (3.9) | 2.0–5.7 | 164 (4.4) | 2.4–6.4 | 156 (4.2) | 2.3–6.2 | 146 (4) | 2.1–5.8 | 228 (6.2) | 3.8–8.5 |
L04AB02 | Infliximab | 207 (5.6) | 3.3–7.9 | 177 (4.8) | 2.8–6.8 | 148 (4) | 2.2–5.8 | 96 (2.6) | 1.1–4.2 | 177 (4.8) | 2.7–6.8 |
L04AB01 | Etanercept | 174 (4.7) | 2.5–7.0 | 131 (3.5) | 1.8–5.3 | 55 (1.5) | 0.4–2.6 | 25 (0.7) | 0.0–1.5 | 149 (4) | 2.1–5.9 |
L04AB04 | Adalimumab | 179 (4.8) | 2.4–7.3 | 158 (4.3) | 2.0–6.5 | 91 (2.5) | 0.8–4.1 | 38 (1) | 0.0–2.1 | 177 (4.8) | 2.4–7.2 |
L04AB06 | Golimumab | 66 (1.8) | 0.4–3.1 | 30 (0.8) | 0.0–1.7 | 10 (0.3) | 0.0–0.8 | 10 (0.3) | 0.0–0.8 | 30 (0.8) | 0.0–1.7 |
L04AC | Interleukin inhibitors | 64 (1.7) | 0.4–3.0 | 30 (0.8) | 0.0–1.8 | 8 (0.2) | 0.0–0.6 | 0 (0.0) | 0.0–0.0 | 30 (0.8) | 0.0–1.8 |
L04AC07 | Tocilizumab | 45 (1.2) | 0.1–2.3 | 23 (0.6) | 0.0–1.5 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 23 (0.6) | 0.0–1.5 |
L04AC05 | Ustekinumab | 8 (0.2) | 0.0–0.6 | 8 (0.2) | 0.0–0.6 | 8 (0.2) | 0.0–0.6 | 0 (0.0) | 0.0–0.0 | 8 (0.2) | 0.0–0.6 |
L04AA33 | Vedolizumab | 17 (0.5) | 0.0–1.1 | 16 (0.4) | 0.0–1.0 | 6 (0.2) | 0.0–0.5 | 6 (0.2) | 0.0–0.5 | 16 (0.4)) | 0.0–1.0 |
L01XC02, L04AA26 | B cell therapy | 6 (0.2) | 0.0–0.5 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 |
L01XC02 | Rituximab | 6 (0.2) | 0.0–0.5 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 |
L04AA26 | Belimumab | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 |
J06BA02 | Immunoglobulins. normal for intravascular administration | 23 (0.6) | 0.0–1.4 | 12 (0.3) | 0.0–0.8 | 40 (1.1) | 0.3–1.9 | 88 (2.4) | 0.9–3.9 | 101 (2.7) | 1.1–4.3 |
L04AA23, L03AX13, L03AB07, L04AX07, L04AA27 | Multiple sclerosis specific drugs | 538 (14.6) | 10.9–18.3 | 303 (8.2) | 5.7–10.8 | 40 (1.1) | 0.1–2.0 | 48 (1.3) | 0.4–2.3 | 316 (8.6) | 5.9–11.2 |
L04AA23 | Natalizumab | 163 (4.4) | 2.5–6.3 | 111 (3) | 1.4–4.6 | 9 (0.2) | 0.0–0.7 | 0 (0.0) | 0.0–0.0 | 111 (3) | 1.4–4.6 |
L03AX13 | Glatiramer acetate | 169 (4.4) | 2.6–6.5 | 94 (2.5) | 1.1–4.0 | 31 (0.8) | 0.0–1.7 | 30 (0.8) | 0.0–1.6 | 100 (2.7) | 1.2–4.2 |
L03AB07 | Interferon beta-1 a | 182 (4.9) | 2.5–7.3 | 74 (2) | 0.8–3.2 | 0 (0.0) | 0.0–0.0 | 13 (0.4) | 0.0–0.8 | 80 (2.2) | 0.9–3.4 |
L04AX07 | Dimethylfumarate | 41 (1.1) | 0.2–2.0 | 25 (0.7) | 0.0–1.3 | 0 (0.0) | 0.0–0.0 | 6 (0.2) | 0.0–0.5 | 25 (0.7) | 0.0–1.3 |
L04AA27 | Fingolimod | 27 (0.7) | 0.0–1.6 | 14 (0.4) | 0.0–1.1 | 0 (0.0) | 0.0–0.0 | 19 (0.5) | 0.0–1.3 | 19 (0.5) | 0.0–1.3 |
J05AR + J05AE01/03/08/10 + J05AF05/07/11 + J05AG01/04/05 + J05AX08/12 | HIV antiretrovirals | 477 (12.9) | 483 (13.1) | 610 (16.5) | 671 (18.2) | 760 (20.6) | |||||
J05AR03 | Tenofovir disoproxil and emtracitabine | 223 (6.0) | 3.7–8.4 | 206 (5.6) | (3.4–7.8) | 235 (6.4) | 4.1–8.6 | 267 (7.)2 | 4.8–9.7 | 304 (8.2) | 5.6–10.9 |
J05AE03 | Ritonavir | 112 (3.0) | 1.5–4.5 | 99 (2.7) | 1.4–4.0 | 179 (4.8) | 2.9–6.8 | 192 (5.2) | 3.2–7.2 | 205 (5.5) | 3.5–7.6 |
D10BA, D10AD | Retinoids for acne treatment | 1641 (44.4) | 38.1–50.8 | 591 (16.0) | 12.3–19.7 | 136 (3.7) | 1.9–5.5 | 105 (2.8) | 1.1–4.6 | 789 (21.4) | 16.9–25.8 |
D10BA01 | Isotretinoin (oral) | 153 (4.1) | 2.2–6.0 | 52 (1.4) | 0.2–2.6 | 0 (0.0) | 0.0–0.0 | 0 (0.0) | 0.0–0.0 | 52 (1.4) | 0.2–2.7 |
D10AD | Topical retinoids | 1488 (40.3) | 34.2–46.3 | 539 (14.6) | 11.1–18.1 | 136 (3.7) | 1.9–5.5 | 105 (2.8) | 1.1–4.6 | 737 (20.0) | 15.7–24.2 |
3.2. Thyroid Therapy
3.2.1. Anti-Hypertensive Drugs
3.2.2. Psychotropic Drugs
3.3. Anti-Diabetics
3.3.1. Obstructive Airway Diseases
3.3.2. Drugs to Treat Auto-Immune Diseases
Systemic Glucocorticoids and Traditional Immunosuppressants
Biologic Immunosuppressants and Intravenous Immunoglobulins (IVIG)
3.3.3. Drugs to Treat Multiple Sclerosis
3.4. Human Immunodeficiency Virus (HIV) Antiretrovirals
3.5. Retinoids
Drugs with Known or Potential Adverse Reaction (ATC Code) | Warnings Regarding Use during Critical Period | Risk Period | Pregnancies Exposed during Risk Period during Study Period (N) | Pregnancies Exposed during Risk Period during Study Period (%, 95%CI) |
---|---|---|---|---|
Methotrexate (L01BA01, L04AX03) | Risk of abortion. Malformations including face, skull, central nervous system, limbs, heart. | T1 (maximal risk between 8–10 GW) | 13 | 0.4 (0.0–1.0/10,000) |
Mycophenolic acid (L04AA06) | Risk of abortion. Malformations including cleft palate, ear deformities in up to 25% of exposed foetuses. | T1 | 11 | 0.3 (0.0–0.8/10,000) |
Cyclophosphamide (L01AA01) | Malformations including the face, skull, eyes and central nervous system. Hematologic anomalies (anemia, leucopenia) in the newborn. | T1 | 0 | 0.0 (0.0–0.0/10,000) |
Carbimazole (H03BB01) | Malformations including aplasia cutis, choanal atreasia, tracheo-esophageal fistula in up to 4% of exposed foetuses. | T1 (maximal risk between 6–10 GW) | 174 | 4.7 (2.7–6.7/10,000) |
Lithium (N05AN01) | Increased risk of heart malformation, especially the Ebstein malformation in 2.5% of exposed babies (including 1% of Ebstein disease vs. 0.005%). | T1 (until GW 10) | 19.6 | 0.5 (0.0–0.1/10,000) |
Dolutegravir (J05AR13) 1 | Suspicion of an increased risk of neural tube defects. | T1 (Maximal risk between 0–4 GW) | 16 | 0.4 (0.4–1.0/10,000) |
Isotretinoin | Malformations including the heart, central nervous system, face, ear, eyes and thymus in up to 20% of exposed foetuses. | T1 | 52 | 1.4 (0.2–2.6/10,000) |
Drugs with Known or Potential Adverse Reaction (ATC Code) | Warnings Regarding Use during Critical Period | Risk Period | Pregnancies Exposed during Risk Period during Study Period (N) | Pregnancies Exposed during Risk Period during Study Period/10,000 95%CI) |
---|---|---|---|---|
Agents acting on the RAA system. (C09) | Renal toxicity which can induce oligo/anamnios, with potential pulmonary, skull hypoplasia and reduction of the extremities. Neonatal renal insufficiency. | T2 and T3 | 105, 72 | 2.8 (1.1–4.5/10,000) 1.9 (0.6–3.2/10,000) |
Psychotropic drugs - Antidepressants; - Antipsychotics; - Benzodiazepines and related drugs (N06A, N05A, N05AN, N05BA, N05CD, N05CF) | -1/3 newborns present transient neonatal symptoms (serotoninergic toxicity or weaning symptoms); - Risk of transient extra-pyramidal symptoms in the newborn; - Prenatal exposure to benzodiazepines with long half-life in may cause impregnation symptoms (sleepiness, suction problems, hypotension, respiratory distress), whereas short half-life substances may cause weaning symptoms (agitation, hyperexcitability). | T3 | 779 | 172.2/10,000 |
Rituximab (L01XC02) | Neonatal B cell depletion | T2 and T3 | 0, 0 | 0.0 (0.0–0.0/10,000) |
Belimumab (L04AA26) | Neonatal B cell depletion | T2 and T3 | 0, 0 | 0.0 (0.0–0.0/10,000) |
Drugs with Potential Adverse Reaction (ATC Code) | Warnings Regarding Use during Critical Period | Risk Period | Pregnancies Exposed during Risk Period during Study Period (N) | Pregnancies Exposed during Risk Period during Study Period (%, 95%CI) |
---|---|---|---|---|
Propylthiouracil (H03BA02) | T1 | 285 | 7.7 (5–10.5/10,000) | |
Mitoxantrone (L01DB07) | Contraception is recommended 4 months after the last administration. | Pre-pregnancy and T1. | 0, 0 | 0.0 (0.0–0.0/10,000) |
Fingolimod (L04AA27) | Contraception is recommended 2 months after the last administration. | 27, 14 | 0.7 (0.0–1.6/10,000) 0.4 (0.0–1.1/10,000) | |
Teriflunomide (L04AA31) | 0, 0 | 0.0 (0.0–0.0/10,000) | ||
Leflunomide (L04AA13) | 0, 0 | 0.0 (0.0–0.0/10,000) | ||
Dimethylfumarate (L04AX07) | Contraception is recommended 3.5 months after the last administration. | 41, 25 | 1.1 (0.2–2.0/10,000), 0.7 (0.0–1.3/10,000) | |
Cladribine (L01BB04, L04AA40) | 0, 0 | 0.0 (0.0–0.0/10,000) | ||
Alemtuzumab (L04AA34) | Contraception is recommended 4 months after the last administration. | 0, 0 | 0.0 (0.0–0.0/10,000) | |
Tofacitinib (L04AA29) [22] | 8, 20 | 0.2 (0.2–0.6/10,000), 0.5 (0.2–1.3/10,000) | ||
Baricitinib (L04AA37) [23] | 0, 0 | 0.0 (0.0–0.0/10,000) |
4. Discussion
4.1. Thyroid Therapy
4.2. Hypertension
4.3. Psychotropic Drugs
4.4. Anti-Diabetics
4.5. Obstructive Airway Diseases
4.5.1. Drugs to Treat Auto-Immune Diseases
Glucocorticoids and Nzon-Biologic Immunosuppressants
Biologic Immunosuppressants and Intravenous Immunoglobulins (ivig)
4.5.2. Drugs to Treat Multiple Sclerosis
4.6. HIV Antiretrovirals
4.7. Retinoids
4.8. Clinical and Policy Implications
4.9. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
Appendix A
Codes | Definition | Type of Delivery |
---|---|---|
TarMed codes version (V01.08.00, 01.08.01, 01.09) | Grossesse et obstétrique | |
22.2110 | Surveillance de la naissance et conduite de l’accouchement, risque normal | Vaginal delivery |
22.2120 | +Césarienne secondaire | Cesarean delivery |
22.2130 | +Hystérectomie lors d’une césarienne | Cesarean delivery |
22.2200 | Surveillance de la naissance et conduite de l’accouchement, haut risque | Vaginal delivery |
22.2210 | Surveillance de la naissance et conduite de l’accouchement, très haut risque | Vaginal delivery |
22.2410 | Césarienne, planifiée ou primaire | Cesarean delivery |
22.2420 | Césarienne itérative | Cesarean delivery |
SwissDRG Codes | MDC 14: Grossesse, naissance et suites de couches | |
O01A (V3.0, V4.0, V5.0, V6.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse jusqu’à 25 semaines complètes ou avec thérapie intra-utérine | Cesarean delivery |
O01A (V7.0) | Césarienne et dialyse, ou thérapie intra-utérine complexe du fœtus | Cesarean delivery |
O01B (V3.0, V4.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse de 26 à 33 semaines complètes, sans thérapie intra-utérine ou avec diagnostic de complication, jusqu’à 25 semaines complètes, ou thromboembolie pendant la période de gestation avec procédure opératoire | Cesarean delivery |
O01B (V5.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse de 26 à 33 semaines complètes, jusqu’à 25 semaines complètes, ou thromboembolie pendant la période de gestation avec procédure opératoire ou procédure complexe | Cesarean delivery |
O01B (V6.0, V7.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse de 26 à 33 semaines ou CC extrêmement sévères ou diagnostic complexe ou procédure de complication, jusqu’à 33 semaines de grossesse ou diagnostic complexe et CC extrêmement sévères, ou jusqu’à 25 semaines de grossesse et diagnostic de complication | Cesarean delivery |
O01C (V3.0, V4.0, V5.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse > 33 semaines complètes, sans thérapie intra-utérine ou avec diagnostic de complication, de 26 à 33 semaines ou avec diagnostic complexe ou jusqu’à 33 semaines ou avec diagnostic complexe, avec CC extrêmement sévères | Cesarean delivery |
O01C (V6.0, V7.0) | Césarienne secondaire avec plusieurs diagnostics de complication ou procédure complexe, ou jusqu’à 33 semaines de grossesse ou diagnostic complexe ou diagnostic de complication et grossesse de 26 à 33 semaines ou diagnostic complexe | Cesarean delivery |
O01D (V3.0, V4.0, V5.0) | Césarienne avec plusieurs diagnostics de complication, durée de la grossesse > 33 semaines complètes, sans thérapie intra-utérine ou avec diagnostic de complication, de 26 à 33 semaines ou avec diagnostic complexe ou jusqu’à 33 semaines ou avec diagnostic complexe, sans CC extrêmement sévères | Cesarean delivery |
O01D (V6.0, V7.0) | Césarienne secondaire avec diagnostic de complication, durée de la grossesse plus de 33 semaines complètes | Cesarean delivery |
O01E (V3.0, V4.0, V5.0) | Césarienne avec diagnostic de complication, durée de la grossesse plus de 33 semaines complètes, sans diagnostic complexe | Cesarean delivery |
O01E (V6.0, V7.0) | Césarienne avec plusieurs diagnostics de complication ou procédure complexe, ou jusqu’à 33 semaines de grossesse ou diagnostic complexe, ou diagnostic de complication et grossesse de 26 à 33 semaines ou diagnostic complexe, ou césarienne secondaire | Cesarean delivery |
O01F (V3.0, V4.0, V5.0) | Césarienne sans diagnostic de complication, durée de la grossesse plus de 33 semaines complètes, sans diagnostic complexe | Cesarean delivery |
O01F (V6.0 V7.0) | Césarienne avec diagnostic de complication, durée de la grossesse plus de 33 semaines complètes | Cesarean delivery |
O01G (V6.0, V7.0) | Césarienne, durée de la grossesse > 33 semaines complètes | Cesarean delivery |
O01H (V7.0) | Césarienne, durée de la grossesse plus de 33 semaines complètes | Cesarean delivery |
O02A (V3.0, V4.0) | Accouchement par voie basse avec procédure opératoire de complication, durée de la grossesse jusqu’à 33 semaines complètes ou avec thérapie intra-utérine | Vaginal delivery |
O02A (V5.0, V6.0, V7.0) | Accouchement par voie basse avec procédure opératoire de complication, avec thérapie intra-utérine ou traitement complexe de soins intensifs > 119 points ou procédure de complication ou procédure complexe | Vaginal delivery |
O02B (V3.0, V4.0) | Accouchement par voie basse avec procédure opératoire de complication, durée de la grossesse plus de 33 semaines complètes, sans thérapie intra-utérine | Vaginal delivery |
O02B (V5.0, V6.0, V7.0) | Accouchement par voie basse avec procédure opératoire de complication | Vaginal delivery |
O60A (V3.0) | Accouchement par voie basse avec plusieurs diagnostics de complication, au moins une complication sévère, durée de la grossesse jusqu’à 33 semaines complètes ou avec procédure de complication | Vaginal delivery |
060A (V 4.0, V5.0, V6.0, V7.0) | Accouchement par voie basse avec plusieurs diagnostics de complication, au moins une complication sévère, durée de la grossesse jusqu’à 33 semaines complètes ou avec procédure de complication ou thromboembolie pendant la période de gestation | Vaginal delivery |
060B (V3.0) | Accouchement par voie basse avec plusieurs diagnostics de complication, au moins une complication sévère, durée de la grossesse plus de 33 semaines complètes, sans procédure de complication ou thromboembolie pendant la période de gestation sans procédure opératoire | Vaginal delivery |
060B (V4.0, V5.0) | Accouchement par voie basse avec plusieurs diagnostics de complication, au moins une complication sévère, durée de la grossesse plus de 33 semaines complètes, sans procédure de complication ou thromboembolie pendant la période de gestation | Vaginal delivery |
O60B (V6.0, V7.0) | Accouchement par voie basse avec plusieurs diagnostics de complication, au moins une complication sévère, durée de la grossesse plus de 33 semaines complètes | Vaginal delivery |
O60C (V3.0, V4.0, V5.0, V6.0, V7.0) | Accouchement par voie basse avec diagnostic de complication sévère ou moyennement sévère | Vaginal delivery |
O60D (V3.0, V4.0) | Accouchement par voie basse sans diagnostic de complication | Vaginal delivery |
060D (V5.0, V6.0, V7.0) | Accouchement par voie basse | Vaginal delivery |
Midwife codes | ||
B1 | Leitung einer ambulanten Geburt | Vaginal delivery |
B2 | Zweithebamme für ambulante Geburt oder Verlegung | Vaginal delivery |
B3 | Verbrauchsmaterial für unvollendete ambulante Geburt | Vaginal delivery |
B4 | Verbrauchsmaterial für ambulante Geburt | Vaginal delivery |
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Gerbier, E.; Graber, S.M.; Rauch, M.; Marxer, C.A.; Meier, C.R.; Baud, D.; Winterfeld, U.; Blozik, E.; Surbek, D.; Spoendlin, J.; et al. Use of Prescribed Drugs to Treat Chronic Diseases during Pregnancy in Outpatient Care in Switzerland between 2014 and 2018: Descriptive Analysis of Swiss Health Care Claims Data. Int. J. Environ. Res. Public Health 2022, 19, 1456. https://doi.org/10.3390/ijerph19031456
Gerbier E, Graber SM, Rauch M, Marxer CA, Meier CR, Baud D, Winterfeld U, Blozik E, Surbek D, Spoendlin J, et al. Use of Prescribed Drugs to Treat Chronic Diseases during Pregnancy in Outpatient Care in Switzerland between 2014 and 2018: Descriptive Analysis of Swiss Health Care Claims Data. International Journal of Environmental Research and Public Health. 2022; 19(3):1456. https://doi.org/10.3390/ijerph19031456
Chicago/Turabian StyleGerbier, Eva, Sereina M. Graber, Marlene Rauch, Carole A. Marxer, Christoph R. Meier, David Baud, Ursula Winterfeld, Eva Blozik, Daniel Surbek, Julia Spoendlin, and et al. 2022. "Use of Prescribed Drugs to Treat Chronic Diseases during Pregnancy in Outpatient Care in Switzerland between 2014 and 2018: Descriptive Analysis of Swiss Health Care Claims Data" International Journal of Environmental Research and Public Health 19, no. 3: 1456. https://doi.org/10.3390/ijerph19031456