(C-065) Age-specific Drug Utilization Patterns Among Pregnant Women in Taiwan: A Nationwide Cohort Study

Background: Drug utilization during pregnancy represents a critical area of public health due to its implications for both maternal and fetal outcomes. Despite its importance, a comprehensive evaluation of trends and patterns in medication use during pregnancy, stratified by maternal age, has not been systematically conducted in Taiwan.

Objectives: The objectives of this study were to analyze the trends in prescription drug utilization among pregnant women in Taiwan from 2004 to 2021, with a primary focus on understanding differences in utilization patterns by maternal age groups ( < 35 years vs. ≥35 years) and their variation across trimesters.

Methods: This nationwide cohort study utilized data from the National Health Insurance (NHI) Database and Birth Certificate Application (BCA) records from 2004 to 2021. Prescription drug utilization was assessed annually, stratified by maternal age and gestational trimester, and categorized using the Anatomical Therapeutic Chemical (ATC) classification system.

Results: Among 3,415,088 pregnancies included in the analysis, the overall prescription drug utilization rate increased from 94% in 2004 to 98% in 2021. In 2021, the most commonly prescribed medications were analgesics (N02, 62%) for pain management, gastrointestinal drugs for functional and acid-related disorders (A03, 58%; A02, 48%), antihistamines (R06, 56%) and cough and cold preparations (R05, 36%) for respiratory conditions, antibiotics (J01, 43%) and gynecological antiinfectives (G02, 31%) for infections, and sex hormones (G03, 48%).

Maternal age stratification revealed notable differences in drug utilization patterns. Pregnant women aged < 35 years had higher prescription rates for analgesics (N02) and gastrointestinal drugs (A03, A02), reflecting a focus on managing pain and digestive issues. In contrast, women aged ≥35 years were more likely to receive antithrombotic agents (B01), cardiovascular drugs (C01, C07), and antibiotics (J01), which align with the increased risk of pregnancy-related complications in advanced maternal age. Trimester-specific analysis revealed the highest prescription rates during the first trimester, with distinct variations in the distribution of ATC categories. For example, gastrointestinal drugs (A02, A03) were predominantly prescribed during the first trimester, while analgesics (N02) peaked during the third trimester.

Conclusions: This study demonstrates a significant upward trend in prescription drug utilization among pregnant women in Taiwan between 2004 and 2021. Maternal age and gestational trimester were key determinants of utilization patterns, emphasizing the need for tailored clinical and public health interventions.