Prevalence and safety of acamprosate use in pregnant alcohol-dependent women in New South Wales, Australia

Erin Kelty, Duong Tran, Tina Lavin, David B. Preen, Gary Hulse, Alys Havard

Research output: Contribution to journalArticle

Abstract

Aims: To estimate the prevalence of exposure to acamprosate in pregnancy in New South Wales (NSW), Australia, to compare the maternal health of women exposed to acamprosate during pregnancy with non-exposed women, and to compare neonatal outcomes in neonates exposed to acamprosate in utero with non-exposed neonates. Design: A population-based retrospective cohort study, comparing maternal and neonatal health outcomes in women exposed to acamprosate during pregnancy with women with a recent history of problematic alcohol use (alcohol comparison group), and women from the general community (community comparison group) using state-wide linked health data. Setting: New South Wales, Australia. Participants: The study included women treated with acamprosate for more than 30 days during pregnancy between 2003 and 2012 (n = 54) and two matched comparison groups (1 : 3); an alcohol comparison group (n = 162) and a community comparison group (n = 162). Measurements: The prevalence of acamprosate exposure was calculated per 100 000 pregnancies. Three primary measures of maternal and neonatal health were used: maternal hospital admissions, birth weight and fetal alcohol syndrome (FAS). Findings: Exposure to acamprosate occurred in 7.7 [95% confidence interval (CI) = 6.0–9.7] in every 100 000 pregnancies. Rates of hospital admissions during pregnancy and 42 days post-partum in acamprosate-treated women were not significantly different from women in the community comparison group [adjusted rate ratio (RR) = 0.85, 95% CI = 0.65–1.11], but were significantly lower compared with the alcohol comparison group (adjusted RR = 1.26, 95% CI = 1.00–1.60). Acamprosate-exposed neonates were not significantly different from the alcohol comparison group or the community comparison group in terms of birth weight or proportion of small-for-gestational-age neonates or incidence of congenital abnormalities (including FAS). Conclusions: The prevalence of acamprosate use in pregnancy in New South Wales, Australia is low. Acamprosate exposure in utero is not clearly associated with poor maternal or neonatal health outcomes.

Original languageEnglish
Pages (from-to)206-215
Number of pages10
JournalAddiction
Volume114
Issue number2
Early online date21 Sep 2018
DOIs
Publication statusPublished - 1 Feb 2019

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South Australia
New South Wales
Alcohols
Safety
Pregnancy
Newborn Infant
Fetal Alcohol Spectrum Disorders
Confidence Intervals
Birth Weight
acamprosate
Term Birth
Gestational Age
Cohort Studies
Research Design
Retrospective Studies
Mothers

Cite this

@article{3a9d35088d3f4b2599d78ce0e7f2c420,
title = "Prevalence and safety of acamprosate use in pregnant alcohol-dependent women in New South Wales, Australia",
abstract = "Aims: To estimate the prevalence of exposure to acamprosate in pregnancy in New South Wales (NSW), Australia, to compare the maternal health of women exposed to acamprosate during pregnancy with non-exposed women, and to compare neonatal outcomes in neonates exposed to acamprosate in utero with non-exposed neonates. Design: A population-based retrospective cohort study, comparing maternal and neonatal health outcomes in women exposed to acamprosate during pregnancy with women with a recent history of problematic alcohol use (alcohol comparison group), and women from the general community (community comparison group) using state-wide linked health data. Setting: New South Wales, Australia. Participants: The study included women treated with acamprosate for more than 30 days during pregnancy between 2003 and 2012 (n = 54) and two matched comparison groups (1 : 3); an alcohol comparison group (n = 162) and a community comparison group (n = 162). Measurements: The prevalence of acamprosate exposure was calculated per 100 000 pregnancies. Three primary measures of maternal and neonatal health were used: maternal hospital admissions, birth weight and fetal alcohol syndrome (FAS). Findings: Exposure to acamprosate occurred in 7.7 [95{\%} confidence interval (CI) = 6.0–9.7] in every 100 000 pregnancies. Rates of hospital admissions during pregnancy and 42 days post-partum in acamprosate-treated women were not significantly different from women in the community comparison group [adjusted rate ratio (RR) = 0.85, 95{\%} CI = 0.65–1.11], but were significantly lower compared with the alcohol comparison group (adjusted RR = 1.26, 95{\%} CI = 1.00–1.60). Acamprosate-exposed neonates were not significantly different from the alcohol comparison group or the community comparison group in terms of birth weight or proportion of small-for-gestational-age neonates or incidence of congenital abnormalities (including FAS). Conclusions: The prevalence of acamprosate use in pregnancy in New South Wales, Australia is low. Acamprosate exposure in utero is not clearly associated with poor maternal or neonatal health outcomes.",
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Prevalence and safety of acamprosate use in pregnant alcohol-dependent women in New South Wales, Australia. / Kelty, Erin; Tran, Duong; Lavin, Tina; Preen, David B.; Hulse, Gary; Havard, Alys.

In: Addiction, Vol. 114, No. 2, 01.02.2019, p. 206-215.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and safety of acamprosate use in pregnant alcohol-dependent women in New South Wales, Australia

AU - Kelty, Erin

AU - Tran, Duong

AU - Lavin, Tina

AU - Preen, David B.

AU - Hulse, Gary

AU - Havard, Alys

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Aims: To estimate the prevalence of exposure to acamprosate in pregnancy in New South Wales (NSW), Australia, to compare the maternal health of women exposed to acamprosate during pregnancy with non-exposed women, and to compare neonatal outcomes in neonates exposed to acamprosate in utero with non-exposed neonates. Design: A population-based retrospective cohort study, comparing maternal and neonatal health outcomes in women exposed to acamprosate during pregnancy with women with a recent history of problematic alcohol use (alcohol comparison group), and women from the general community (community comparison group) using state-wide linked health data. Setting: New South Wales, Australia. Participants: The study included women treated with acamprosate for more than 30 days during pregnancy between 2003 and 2012 (n = 54) and two matched comparison groups (1 : 3); an alcohol comparison group (n = 162) and a community comparison group (n = 162). Measurements: The prevalence of acamprosate exposure was calculated per 100 000 pregnancies. Three primary measures of maternal and neonatal health were used: maternal hospital admissions, birth weight and fetal alcohol syndrome (FAS). Findings: Exposure to acamprosate occurred in 7.7 [95% confidence interval (CI) = 6.0–9.7] in every 100 000 pregnancies. Rates of hospital admissions during pregnancy and 42 days post-partum in acamprosate-treated women were not significantly different from women in the community comparison group [adjusted rate ratio (RR) = 0.85, 95% CI = 0.65–1.11], but were significantly lower compared with the alcohol comparison group (adjusted RR = 1.26, 95% CI = 1.00–1.60). Acamprosate-exposed neonates were not significantly different from the alcohol comparison group or the community comparison group in terms of birth weight or proportion of small-for-gestational-age neonates or incidence of congenital abnormalities (including FAS). Conclusions: The prevalence of acamprosate use in pregnancy in New South Wales, Australia is low. Acamprosate exposure in utero is not clearly associated with poor maternal or neonatal health outcomes.

AB - Aims: To estimate the prevalence of exposure to acamprosate in pregnancy in New South Wales (NSW), Australia, to compare the maternal health of women exposed to acamprosate during pregnancy with non-exposed women, and to compare neonatal outcomes in neonates exposed to acamprosate in utero with non-exposed neonates. Design: A population-based retrospective cohort study, comparing maternal and neonatal health outcomes in women exposed to acamprosate during pregnancy with women with a recent history of problematic alcohol use (alcohol comparison group), and women from the general community (community comparison group) using state-wide linked health data. Setting: New South Wales, Australia. Participants: The study included women treated with acamprosate for more than 30 days during pregnancy between 2003 and 2012 (n = 54) and two matched comparison groups (1 : 3); an alcohol comparison group (n = 162) and a community comparison group (n = 162). Measurements: The prevalence of acamprosate exposure was calculated per 100 000 pregnancies. Three primary measures of maternal and neonatal health were used: maternal hospital admissions, birth weight and fetal alcohol syndrome (FAS). Findings: Exposure to acamprosate occurred in 7.7 [95% confidence interval (CI) = 6.0–9.7] in every 100 000 pregnancies. Rates of hospital admissions during pregnancy and 42 days post-partum in acamprosate-treated women were not significantly different from women in the community comparison group [adjusted rate ratio (RR) = 0.85, 95% CI = 0.65–1.11], but were significantly lower compared with the alcohol comparison group (adjusted RR = 1.26, 95% CI = 1.00–1.60). Acamprosate-exposed neonates were not significantly different from the alcohol comparison group or the community comparison group in terms of birth weight or proportion of small-for-gestational-age neonates or incidence of congenital abnormalities (including FAS). Conclusions: The prevalence of acamprosate use in pregnancy in New South Wales, Australia is low. Acamprosate exposure in utero is not clearly associated with poor maternal or neonatal health outcomes.

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KW - alcohol

KW - birth defects

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