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\begin{document}

\title{Changes in antiepileptic drug prescriptions over a decade in
childbearing women in Lombardy Region, Italy}



\author[1]{Antonio Clavenna}%
\author[1]{Rita Campi}%
\author[1]{Daria Putignano}%
\author[2]{Ida Fortino}%
\author[1]{Maurizio Bonati}%
\affil[1]{Istituto di Ricerche Farmacologiche Mario Negri}%
\affil[2]{Lombardy Region}%


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  \date{May 20, 2024}


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\begin{abstract}
Aim To describe the antiepileptic drug (AED) prescription pattern in
pregnant women and women of childbearing age in the 2010-2019 period in
the Lombardy region, Italy. Methods The Lombardy region administrative
healthcare databases (2010-2019) were analysed. AEDs were classified as
drugs belonging to the N03A subgroup of the Anatomical Therapeutic
Chemical Classification System. Women 15-49 years old were considered as
women of childbearing age, while exposure during pregnancy was estimated
taking into account the 12 months before delivery (International
Classification of Diseases, Ninth Revision, Clinical Modification,
ICD-9-CM codes in the diagnosis record from 650 to 659). Results During
2019, 16,605 women of childbearing age (prevalence: 14.8%0) received at
least one AED prescription. Pregabalin was the most widely used
antiepileptic in women of childbearing age (22.3\%), followed by
valproic acid (20.0\%). The prevalence of AED prescription in pregnant
women was 3.8%0, and levetiracetam and lamotrigine (16.6\%) were the most
commonly prescribed drugs. The prevalence of AED prescription did not
change from 2010 to 2019 in women of childbearing age or in pregnant
women. Valproic acid was one of the most used AEDs in pregnancy until
2016, after which its prescription declined from 19\% to 14\% of AED
users. Conclusions Despite the decrease in valproic acid prescription
over time, this drug is still among the most used AEDs, in particular in
women of childbearing age. Educational interventions for healthcare
professionals and women are needed in order to reduce the risk of
unplanned pregnancy.%
\end{abstract}%



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