NCT06744673 - A Study to Assess the Pregnancy Outcome in Women Exposed to Dayvigo® During Pregnancy Compared to an Unexposed Control Population | Crick

Eligibility

Sex: FEMALEMin age: 16 YearsMax age: 49 YearsHealthy volunteers:

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Inclusion Criteria: 1. Must be female. 2. Must be 16 to 49 years of age 3. Has a clinically recognized pregnancy that overlaps with the data collection period between 01 Jun 2020 and the end of the data collection period 4. Has continuous medical and pharmacy benefit coverage for a minimum of 6 months (Baseline Period) before the estimated date of conception and through the date of pregnancy outcome. Cohort A: 1. Exposed to at least 1 dose of Dayvigo at any time from 10 days after the LMP, that is, approximately 4 days prior to the estimated DOC, defined as 14 days after the LMP, based on the product's half-life, until the pregnancy outcome 2. Has a diagnosis of insomnia recorded in her electronic healthcare data within 6 months before the estimated DOC, insomnia defined as an International Classification of Disease (ICD) 10-CM code G47.0x Insomnia or ICD 10 CM code F51.0x Insomnia not due to a substance or known physiological condition or Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) code 780.52. Or if the first exposure to Dayvigo occurs after the DOC, then must have a diagnostic code for insomnia prior to or on the first exposure to this drug. Cohort B: 1. Exposed to at least 1 dose of prescription medication for insomnia other than Dayvigo from 5 times the product's half-life prior to the estimated DOC until the pregnancy outcome (that is, any trimester) 2. Has a diagnosis of insomnia recorded in her electronic healthcare data within 6 months before the estimated DOC, insomnia defined as an ICD 10-CM code G47.0x Insomnia or ICD 10 CM code F51.0x Insomnia not due to a substance or known physiological condition or DSM-5 code 780.52. Or if the first exposure to the prescription insomnia medication occurs after the DOC, then must have a diagnostic code for insomnia prior to or on the first exposure to this drug Cohort C: 1. Not exposed to any prescription medication for the treatment of insomnia during pregnancy that is, from 5 times the product's half-life prior to the estimated DOC until the pregnancy outcome (that is, any trimester). NB: May be exposed during pregnancy to other drugs (that is, not for insomnia), but only provided that these are not associated with potential or known teratogenicity 2. Has a diagnosis of insomnia recorded in her electronic healthcare data within 6 months before the estimated DOC, insomnia defined as an ICD 10-CM code G47.0x Insomnia or ICD 10 CM code F51.0x Insomnia not due to a substance or known physiological condition or DSM-5 code 780.52 Exclusion Criteria: 1. Identified pregnancies with exposure to known teratogens during pregnancy, that is, from 14 days after the LMP to pregnancy outcome (any trimester) or to dual orexin receptor antagonists other than lemborexant (this includes, but it is not limited to, exclusion of suvorexant and daridorexant) from 5 times the product's half-life prior to the estimated DOC until the pregnancy outcome (any trimester) will be excluded 2. Pregnancies not associated with a known pregnancy outcome.

Outcomes

Primary Outcomes

Percentage of Live Births Reported With MCM in Women of Cohort A Subset and Cohort C

MCM will be defined as an abnormality of body structure or function that is present at birth, is of prenatal origin (that is, birth defect), has significant medical, social, or cosmetic consequences for the affected individual, and typically requires medical intervention. Congenital anomalies will be classified using the Centers for Disease Control and Prevention (CDC)'s Metropolitan Atlanta Congenital Defects Program (MACDP) system. Live birth will be defined as birth of a living fetus at greater than or equal to (\>=) 20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 grams (g). Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy.

Time frame: At estimated date of delivery (EDD)/pregnancy outcome (up to 1 year 10 months)

Percentage of Live Births Reported With MCM in Women of Cohort A and Cohort B Subsets

MCM will be defined as an abnormality of body structure or function that is present at birth, is of prenatal origin (that is, birth defect), has significant medical, social, or cosmetic consequences for the affected individual, and typically requires medical intervention. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Secondary Outcomes

Percentage of Live Births and Fetal Losses With MCM in Women of Cohort A and Cohort B Subsets

MCM will be defined as an abnormality of body structure or function that is present at birth, is of prenatal origin (that is, birth defect), has significant medical, social, or cosmetic consequences for the affected individual, and typically requires medical intervention. Congenital anomalies will be classified using the CDC's MACDP system. Live birth will be defined as birth of a living fetus at \>=20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 g. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Percentage of Live Births and Fetal Losses With MCM in Women of Cohort A Subset and Cohort C

MCM will be defined as an abnormality of body structure or function that is present at birth, is of prenatal origin (that is, birth defect), has significant medical, social, or cosmetic consequences for the affected individual, and typically requires medical intervention. Congenital anomalies will be classified using the CDC's MACDP system. Live birth will be defined as birth of a living fetus at \>=20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 g. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy.

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Spontaneous Abortion (SAB) in Cohort A and Cohort B Subsets

SAB is defined as an involuntary fetal loss or the expulsion of the products of conception occurring at less than (\<) 20 gestational weeks. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With SAB in Cohort A Subset and Cohort C

SAB is defined as an involuntary fetal loss or the expulsion of the products of conception occurring at \<20 gestational weeks. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Stillbirth in Cohort A and Cohort B Subsets

Stillbirth is defined by the American College of Obstetricians and Gynecologists (ACOG), an involuntary fetal loss occurring at \>=20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 g. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: From 20 gestational weeks up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Stillbirth in Cohort A Subset and Cohort C

Stillbirth is defined by the ACOG, an involuntary fetal loss occurring at \>=20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 g. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy.

Time frame: From 20 gestational weeks up to EDD/ pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Preterm Birth in Cohort A and Cohort B Subsets

Preterm birth is defined as a live birth occurring at \<37 gestational weeks. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Preterm Birth in Cohort A Subset and Cohort C

Preterm birth is defined as a live birth occurring at \<37 gestational weeks. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Induced Termination in Cohort A and Cohort B Subsets

Induced termination is defined as a pregnancy terminated according to the participant's decision (elective termination), with or without medical or therapeutic indication (therapeutic indication occurs when the pregnancy endangers the mother's health or the fetus has a condition incompatible with normal life). Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: From enrollment up to date of induced termination (up to 1 year 10 months)

Percentage of Participants With Induced Termination in Cohort A Subset and Cohort C

Time frame: From enrollment up to date of induced termination (up to 1 year 10 months)

Percentage of Infants With Small for Gestational Age (SGA) in Cohort A and Cohort B Subsets

SGA will be evaluated as weight at birth in \<10th percentile for sex and gestational age using standard growth charts for full and preterm live-born infants. Cohort A subset is defined as women with insomnia who are exposed to Dayvigo during the 1st trimester of pregnancy and Cohort B subset is defined as women with insomnia who are exposed to a prescription insomnia drug other than Dayvigo during the 1st trimester of pregnancy.

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Percentage of Infants With SGA in Cohort A Subset and Cohort C

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Percentage of Live Births and Fetal Losses With MCM in Women of Cohort A, B and C

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With SAB in Cohort A, B and C

SAB is defined as an involuntary fetal loss or the expulsion of the products of conception occurring at less than (\<) 20 gestational weeks.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Stillbirth in Cohort A, B and C

Stillbirth is defined by the ACOG, an involuntary fetal loss occurring at \>=20 gestational weeks or, if gestational age is unknown, a fetus weighing \>=350 g.

Time frame: From 20 gestational weeks up to EDD/ pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Preterm Birth in Cohort A, B and C

Preterm birth is defined as a live birth occurring at \<37 gestational weeks.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

Percentage of Participants With Induced Termination in Cohort A, B and C

Time frame: From enrollment up to date of induced termination (up to 1 year 10 months)

Percentage of Infants With SGA in Cohort A, B and C

SGA will be evaluated as weight at birth in \<10th percentile for sex and gestational age using standard growth charts for full and preterm live-born infants.

Time frame: At EDD/pregnancy outcome (up to 1 year 10 months)

Number of MCM From Postmortem With Non-live Birth in Cohort A and Cohort B

Any findings of MCMs from postmortem examination of pregnancies with non-live birth outcomes (that is, abortions, fetal deaths/stillbirths) will be reported separately.

Time frame: From enrollment up to pregnancy outcome (up to 1 year 10 months)

A Study to Assess the Pregnancy Outcome in Women Exposed to Dayvigo® During Pregnancy Compared to an Unexposed Control Population

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes