TY - JOUR
T1 - Medication prescribing and pregnancy-related risk factors for women with type 2 diabetes of reproductive age within primary care
T2 - a cross-sectional investigation for the PREPARED study
AU - Famiglietti, Alexandra M.
AU - Parsons, Judith
AU - Chua, Kia Chong
AU - Hodgkinson, Anna
AU - Abiola, Olubunmi
AU - Brackenridge, Anna
AU - Banerjee, Anita
AU - Chamley, Mark
AU - Hopkins, Lily
AU - Hunt, Katharine F.
AU - Murphy, Helen
AU - Rogers, Helen
AU - Steele, Gavin
AU - Winkley, Kirsty
AU - Forbes, Angus
AU - Forde, Rita
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
PY - 2025/3/5
Y1 - 2025/3/5
N2 - Introduction Women with type 2 diabetes are at risk of commencing pregnancy while using medications that are either not recommended for pregnancy or with known teratogenicity, which may contribute to adverse pregnancy outcomes. In this study, we aimed to characterize pregnancy-related risk factors and medication exposures among women with type 2 diabetes. Research design and methods Individual health characteristics, sociodemographic information, and prescription data were extracted from the primary care records of women aged 18-45 years with type 2 diabetes in participating general practices in the UK. Prescribed medications were categorized according to suitability for pregnancy: recommended, not recommended, or not recommended but used if clinically indicated. Logistic regression was used to estimate associations between individual characteristics and medications not recommended for pregnancy. Results Data on 725 women were extracted. Prescribed medications suggested the presence of numerous comorbidities, with diabetes medications (65%, n=471) and statins (20%, n=145) most frequently prescribed. 37% (n=268) of women took ≥3 medications, and a third (n=269) took medications not recommended for pregnancy. Among those not prescribed contraception (89%, n=646), no one met all clinically recommended pre-pregnancy criteria. In multivariable logistic regression analysis, polypharmacy (OR 3.49 95% CI 2.88 to 4.30) and age (OR 1.04 95% CI 1.00 to 1.09) were associated with use of medications not recommended for pregnancy. Conclusions Women with type 2 diabetes have suboptimal contraceptive provision despite multiple exposures to medications not recommended for pregnancy. Regular assessment of contraceptive use, reproductive intentions, and medication review is urgently needed in primary care settings to minimize pregnancy-related risks.
AB - Introduction Women with type 2 diabetes are at risk of commencing pregnancy while using medications that are either not recommended for pregnancy or with known teratogenicity, which may contribute to adverse pregnancy outcomes. In this study, we aimed to characterize pregnancy-related risk factors and medication exposures among women with type 2 diabetes. Research design and methods Individual health characteristics, sociodemographic information, and prescription data were extracted from the primary care records of women aged 18-45 years with type 2 diabetes in participating general practices in the UK. Prescribed medications were categorized according to suitability for pregnancy: recommended, not recommended, or not recommended but used if clinically indicated. Logistic regression was used to estimate associations between individual characteristics and medications not recommended for pregnancy. Results Data on 725 women were extracted. Prescribed medications suggested the presence of numerous comorbidities, with diabetes medications (65%, n=471) and statins (20%, n=145) most frequently prescribed. 37% (n=268) of women took ≥3 medications, and a third (n=269) took medications not recommended for pregnancy. Among those not prescribed contraception (89%, n=646), no one met all clinically recommended pre-pregnancy criteria. In multivariable logistic regression analysis, polypharmacy (OR 3.49 95% CI 2.88 to 4.30) and age (OR 1.04 95% CI 1.00 to 1.09) were associated with use of medications not recommended for pregnancy. Conclusions Women with type 2 diabetes have suboptimal contraceptive provision despite multiple exposures to medications not recommended for pregnancy. Regular assessment of contraceptive use, reproductive intentions, and medication review is urgently needed in primary care settings to minimize pregnancy-related risks.
KW - Contraception
KW - Pregnancy
KW - Primary Health Care
KW - Type 2 Diabetes
UR - http://www.scopus.com/inward/record.url?scp=86000638714&partnerID=8YFLogxK
U2 - 10.1136/bmjdrc-2024-004312
DO - 10.1136/bmjdrc-2024-004312
M3 - Article
C2 - 40044453
AN - SCOPUS:86000638714
SN - 2052-4897
VL - 13
JO - BMJ Open Diabetes Research and Care
JF - BMJ Open Diabetes Research and Care
IS - 2
M1 - e004312
ER -
