Background: Although bacterial infections may be more frequent during pregnancy, the prescription of antibiotics to pregnant women represents a challenge for physicians driven by the benefit-risk balance.
Objectives: To assess the extent of antibiotic exposure during pregnancy and its associated factors.
Methods: This drug utilisation study included all pregnancies ending between 2010 and 2019 in the National Mother-Child EPI-MERES Register (etablished from the French National Health Data System). Antibiotic exposure was defined as having at least one antibiotic prescription filled during pregnancy. The prevalence of pregnancies exposed to antibiotics was calculated. Univariable Poisson regression with generalised estimating equations was used to compare the number of antibiotic prescriptions filled during pregnancy with periods one year before and after pregnancy. Multivariable Poisson regression was used to investigate factors associated with antibiotic exposure during pregnancy.
Results: Among 9,865,236 pregnancies, 3,531,690 (35.8%) were exposed to antibiotics. The prevalence of antibiotic exposure during pregnancy substantially decreased from 38.0% in 2010 to 32.1% in 2019. Amoxicillin was the most commonly filled antibiotic during pregnancy. More than 56% of antibiotics were prescribed by general practitioners.Compared with a similar period one year before pregnancy, the number of filled antibiotic prescriptions was lower during pregnancy [Incidence rate ratio (IRR) 0.903, 95% CI 0.902-0.905] and during period one year after pregnancy [IRR 0.880, 95%CI 0.879-0.881]. Region of residence, deprivation index, smoking-related conditions, and chronic diseases (especially chronic respiratory diseases) were associated with antibiotic exposure during pregnancy.
Conclusions: Despite the high prevalence of antibiotic exposure, antibiotic prescriptions were filled less frequently during pregnancy than the preceding year. This may be due to a more relevant benefit-risk assessment. Women living with social deprivation and in specific regions, those with smoking disorders, and those with chronic diseases were more likely to fill antibiotic prescriptions during pregnancy.
