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Antihypertensive drug use during pregnancy in Japan

Hypertension Research volume 46, pages 548–549 (2023)Cite this article

Considering the late marriages and increasing proportion of births among women with advanced maternal age in Japan [1], the number of women who need drug treatment during pregnancy and its oppotunity are increasing, and we believe that perinatal pharmacoepidemiology is becoming increasingly important. In this context, we read the article by Taguchi et al. [2] with great interest.

We wondered if there might be a limitation resulting from the receipt data and evaluated the usage of antihypertensive drugs in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which recruited 22,493 pregnant women in 2013–2016 [3]. Among the 1,875 pregnant women with hypertensive disorders of pregnancy (HDP) participating in the TMM BirThree Cohort Study, we found that the percentage of antihypertensive drug use was 2.9% (n = 55) in early pregnancy and 3.4% (n = 63) in mid-pregnancy (Table 1), which is approximately the same as the percentage of prescriptions for HDP patients in the Japan Medical Data Center (JMDC) (4% in early pregnancy, 4% in mid-pregnancy and 10% in late pregnancy), considering the gap between the use and prescription of the drug. In terms of prescribing trends during pregnancy, the percentage of nifedipine use in early pregnancy in the TMM BirThree Cohort Study was not as high as that in the JMDC, but the trend of nifedipine use was definitely toward an increase. Furthermore, the percentage of nifedipine prescriptions increased from early to mid-pregnancy, as it is recommended for use after 20 gestational weeks. Among the percentage of antihypertensive drug prescriptions throughout pregnancy, nifedipine exceeded methyldopa after 2017 [2]. These observations suggest that the results from the JMDC database and those of the TMM BirThree Cohort Study, in which maternal recruitment was complete by 2016, are equivalent.

Table 1 Antihypertensive drugs used among 1,875 pregnant women with HDP in the TMM BirThree cohort study
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References

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Acknowledgements

This work was supported by the Japan Agency for Medical Research and Development (AMED, Japan) (grant numbers JP17km0105001 and JP21tm0124005). A full list of members of Tohoku Medical Megabank Organization is available at https://www.megabank.tohoku.ac.jp/english/a220901/ for ToMMo.

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Authors and Affiliations

  1. Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan

    Taku Obara, Mami Ishikuro, Fumihiko Ueno, Aoi Noda, Keiko Murakami & Shinichi Kuriyama

  2. Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Taku Obara, Mami Ishikuro, Fumihiko Ueno, Aoi Noda, Keiko Murakami & Shinichi Kuriyama

  3. Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan

    Taku Obara & Aoi Noda

  4. International Research Institute of Disaster Science, Sendai, Japan

    Shinichi Kuriyama

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  1. Taku Obara
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Correspondence to Taku Obara.

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Obara, T., Ishikuro, M., Ueno, F. et al. Antihypertensive drug use during pregnancy in Japan. Hypertens Res 46, 548–549 (2023). https://doi.org/10.1038/s41440-022-01101-0

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