{"id":6650,"date":"2016-04-25T00:00:00","date_gmt":"2016-04-25T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy\/"},"modified":"2023-06-14T20:00:48","modified_gmt":"2023-06-15T00:00:48","slug":"occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy\/","title":{"rendered":"Occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4 provinces: British Columbia, Saskatchewan, Manitoba and Ontario. <\/p>\n<p><strong>Methods<\/strong> &#x2014; Using administrative data, we identified 4 historical cohorts of female users of isotretinoin (aged 12&#x2013;48 yr) for the period 1996 to 2011. We defined pregnancy using International Statistical Classification of Diseases and billing codes. One definition included only cases with documented pregnancy outcomes (high-specificity definition); the other definition also included individuals recorded as receiving prenatal care (high-sensitivity definition). We studied new courses of isotretinoin and detected pregnancies in 2 time windows: during isotretinoin treatment only and up to 42 weeks after treatment. Live births were followed for 1 year to identify congenital malformations. <\/p>\n<p><strong>Results<\/strong> &#x2014; A total of 59 271 female patients received 102 308 courses of isotretinoin. Between 24.3% and 32.9% of participants received prescriptions for oral contraceptives while they were taking isotretinoin, compared with 28.3% to 35.9% in the 12 months before isotretinoin was started. According to the high-specificity definition of pregnancy, there were 186 pregnancies during isotretinoin treatment (3.1\/1000 isotretinoin users), compared with 367 (6.2\/1000 users) according to the high-sensitivity definition. By 42 weeks after treatment, there were 1473 pregnancies (24.9\/1000 users), according to the highspecificity definition. Of these, 1331 (90.4%) terminated spontaneously or were terminated by medical intervention. Among the 118 live births were 11 (9.3%) cases of congenital malformation. Pregnancy rates during isotretinoin treatment remained constant between 1996 and 2011. <\/p>\n<p><strong>Interpretation<\/strong> &#x2014; Adherence to the isotretinoin pregnancy prevention program in Canada was poor during the 15-year period of this study.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4 provinces: British [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[26,56,45],"migration-helper-qa-sample-set":[],"class_list":["post-6650","journal_article","type-journal_article","status-publish","hentry","topic-maternity-and-neonatal-care","topic-pharmacoepidemiology-and-drug-safety","topic-reproductive-medicine"],"acf":{"citation":"Henry D, Dormuth C, Winquist B, Carney G, Bugden S, Teare G, L&#xe9;vesque LE, B&#xe9;rard A, Paterson JM, Platt RW; CNODES (Canadian Network for Observational Drug Effect Studies) Investigators.<em> CMAJ<\/em>. 2016; 188(10):723-30. Epub 2016 Apr 25.","source_url":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4938682\/","ices_scientist":[1266,1100],"site":[6733,6736],"research_program":[6746],"news_release":[7648],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"BEEF9590-07A1-4B92-9D11-C14E39B7F49E","sitecore_item_name":"Occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy","sitecore_field_values":"{\n  \"__Valid from\": \"20170811T145407\",\n  \"Title\": \"Occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy\",\n  \"Short title\": \"Occurrence of pregnancy and\",\n  \"Summary\": \"Adherence to the isotretinoin pregnancy prevention program in Canada was poor during the 15-year period of this study.\",\n  \"Citation\": \"<p>Henry D, Dormuth C, Winquist B, Carney G, Bugden S, Teare G, L&eacute;vesque LE, B&eacute;rard A, Paterson JM, Platt RW; CNODES (Canadian Network for Observational Drug Effect Studies) Investigators.<em> CMAJ<\/em>. 2016; 188(10):723-30. Epub 2016 Apr 25.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4 provinces: British Columbia, Saskatchewan, Manitoba and Ontario. <\/p>n<p><strong>Methods<\/strong> &mdash; Using administrative data, we identified 4 historical cohorts of female users of isotretinoin (aged 12&ndash;48 yr) for the period 1996 to 2011. We defined pregnancy using International Statistical Classification of Diseases and billing codes. One definition included only cases with documented pregnancy outcomes (high-specificity definition); the other definition also included individuals recorded as receiving prenatal care (high-sensitivity definition). We studied new courses of isotretinoin and detected pregnancies in 2 time windows: during isotretinoin treatment only and up to 42 weeks after treatment. Live births were followed for 1 year to identify congenital malformations. <\/p>n<p><strong>Results<\/strong> &mdash; A total of 59 271 female patients received 102 308 courses of isotretinoin. Between 24.3% and 32.9% of participants received prescriptions for oral contraceptives while they were taking isotretinoin, compared with 28.3% to 35.9% in the 12 months before isotretinoin was started. According to the high-specificity definition of pregnancy, there were 186 pregnancies during isotretinoin treatment (3.1\/1000 isotretinoin users), compared with 367 (6.2\/1000 users) according to the high-sensitivity definition. By 42 weeks after treatment, there were 1473 pregnancies (24.9\/1000 users), according to the highspecificity definition. Of these, 1331 (90.4%) terminated spontaneously or were terminated by medical intervention. Among the 118 live births were 11 (9.3%) cases of congenital malformation. Pregnancy rates during isotretinoin treatment remained constant between 1996 and 2011. <\/p>n<p><strong>Interpretation<\/strong> &mdash; Adherence to the isotretinoin pregnancy prevention program in Canada was poor during the 15-year period of this study.<\/p>n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4938682\/\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{3B67F4BE-E30A-434A-8669-AE2A085C94E0}|{C23CD67A-AE59-4EFC-816C-4F073E0DF586}|{E86C786D-011F-4280-894D-32554E81838A}|{943D2F14-1BF9-4089-B385-55664C739674}\",\n  \"Related Products\": \"<h2>NEWS RELEASE<\/h2>rn<h3><a href=\"~\/link.aspx?_id=5BCA7A833318495D8302CDE1881D7445&amp;_z=z\">Poor contraceptive practices are leading to pregnancies in users of isotretinoin, a drug that causes birth defects<\/a><\/h3>rn<h2>PODCAST<\/h2>rn<h3><a href=\"https:\/\/soundcloud.com\/cmajpodcasts\/151243-res\" title=\"Opens in new window\" target=\"_blank\">CMAJ podcast with co-investigator Brandace Winquist<\/a><\/h3>rn<h2>ICES IN THE NEWS<\/h2>rn<h3><a href=\"http:\/\/www.cbc.ca\/news\/health\/acne-accutane-pregnancy-1.3551549\" title=\"Opens in new window\" target=\"_blank\">Acne drug Accutane's harm to fetus a worry despite prevention efforts<\/a><\/h3>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}|{5A12C65D-3CDA-413E-BC94-C1D778156CE6}\",\n  \"ICES Scientists\": \"{242795DE-E521-4AAA-A4DF-93AF84CC17CA}|{4A1034A0-5248-46A2-805E-20FBC57B1237}|{562A208E-BE60-4773-BD4A-AA2B0E1667C1}\",\n  \"Posted Date\": \"20160425T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2016\/January\/Occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/occurrence-of-pregnancy-and-pregnancy-outcomes-during-isotretinoin-therapy\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; Isotretinoin, a teratogen, is widely used to treat cystic acne. 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