Drugs and pregnancy: effects on fetal morphology
DOI:
https://doi.org/10.33448/rsd-v9i7.4984Keywords:
Risk factors; Fetal development; Pregnancy; Drug-induced abnormalities.Abstract
Objective: To determine whether the use of licit and illicit drugs, the use of antibiotics, medicinal plants and drugs acting on the central nervous system are risk factors for structural fetal changes. Methods: Case-control study, conducted between July 2017 and October 2018, in a public fetal medicine hospital. The case population consisted of 202 pregnant women of fetuses with structural malformations and the control population of 80 pregnant women. A questionnaire was applied before the ultrasound evaluation, in order to analyze the clinical and epidemiological data. Results: The ingestion of amoxicillin (OR: 0.35), spiramycin (OR: 0.05), passionflower (OR: 0.09) and sertraline (OR: 0.18) showed a negative association, with indicative of protection against malformations fetal structures. There was an inappropriate use of folic acid and high consumption of medications. Conclusion: The use of alcohol, cigarettes, illicit drugs, antibiotics, medicinal plants and drugs that act on the central nervous system did not define an increased risk for structural fetal malformations. However, it demonstrates the lack of awareness about the importance of family planning and the dangers of using drugs during pregnancy.
References
Andrade, A.M., Ramalho, A.A., Koifman, R.J., Dotto, L.M.G., Cunha, M.A., & Opitz, S.P. (2014). Fatores associados ao uso de medicamentos na gestação em primigestas no município de Rio Branco, Acre, Brasil. Cad Saúde Pública, 30 (5), 1-6. doi: /10.1590/0102-311X00172412.
Andrade, J.V., Resende, C.T.A., Correia, J.C.F.N.S.C., Martins, C.M.B.S.C., Faria, C.C.F., Figueiredo, M.C.M., Bastos, V.M.N., Andrade, N.J.S., & Andrade, I.G.M.V. (2018). Recém-nascidos com risco de toxoplasmose congênita, revisão de 16 anos. Sci Med, 28 (4), ID32169. doi: 10.15448/1980-6108.2018.4.32169
Bhuiyan, M., Petropoulos, S., Gibb, W., & Matthew, S. (2012). Sertraline Alters Multidrug Resistance Phosphoglycoprotein Activity in the Mouse Placenta and Fetal Blood–Brain Barrier. Reproductive Sciences, 19 (4), 407-415. doi: 10.1177/1933719111424438
Boll, K.M., Bortolasci, C.C., Zaminelli, T., Veríssimo, L.F., Bacchi, A.D., & Higachi, L. (2014). Passiflora incarnata treatment during gestation and lactation: toxicological and antioxidante evaluation in Wister dams. Braz J Pharm Sciences, 50, 353-359. doi: doi.org/10.1590/S1984-82502014000200015
Borges, V.M., Moura, F., Cerdeira, C.D., & Barros, G.B.S. (2018). Uso de medicamentos entre gestantes de um município no sul de Minas Gerais, Brasil. Infarma Ciências Farmacêuticas, 30 (1), 30-43. doi: /10.14450/2318-9312.v30.e1.a2018.pp30-43
Brasil. (2019). Ministério da Saúde. Data SUS. Disponível em http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sim/cnv/fet10uf.def. Acesso em 20 de janeiro de 2020
Cosme, H.W., Lima, L.S., & Barbosa, L.G. (2017). Prevalência de anomalias congênitas e fatores associados em recém-nascidos do município de São Paulo no período de 2010 a 2014. Rev Paul Pediatr, 35 (1), 33-38. doi: 10.1590/1984-0462/;2017;35;1;00002
Costa, D.B., Coelho, H.L.L., & Santos, D.B. (2017). Use of medicines before and during pregnancy: prevalence and associated factors. Cad Saúde Pública, 33 (2), e00126215. doi: /10.1590/0102-311x00126215
Daniel, S., Doron, M., Fishman, B., Koren, G., Lunenfeld, E., & Levy, A. (2019).The safety of using amoxicillin and clavulanic acid during the first trimester of pregnancy. Br J Clin Pharmacol, 5. doi: 10.1111 / bcp.14118
Gilbert, R.E., Gras, L., Wallon, M., Peyron, F., Ades, A.E., & Dunn, DT. (2001). Effect of prenatal treatment on mother to child transmission of toxoplasma gondii: retrospective cohort study of 554 mother-child pairs in Lyon, France. Int J Epidemiol, 30, 1303-8. doi: 10.1093 / ije / 30.6.1303
Holness, H. (2018). High-Risk Pregnancy. North American Nursing Clinics, 53 (2), 241-51. doi: 10.1016 / j.cnur.2018.01.010.
Huybrechts, K.F., Palmsten, K., Avorn, J., Cohen, L.S., Holmes, L.B., Franklin, J.M., Mogun, H., Levin, R., Kowal, M., Setoguchi, S., & Hernandez-diaz, S. (2014). Use of antidepressants in pregnancy and risk of heart defects. N Engl J Med, 370, 2397-2407. doi: 10.1056 / NEJMoa1312828
Kapoor, A., Iqbal, M., Petropoulos, S., Ho, H.L., Gibb, W., & Mattheus, S.G. (2013). Effects of Sertraline and Fluoxetine on P-Glycoprotein at Barrier Sites: In Vivo and In Vitro Approaches. Plos One, 8(2), e56525. doi: 10.1371/journal.pone.0056525
Khan, H. & Nabavi, S.M. (2019). Passiflora (Passiflora incarnata). Nonvitamin and Nonmineral Nutritional Supplements, 361-366. doi: https://doi.org/10.1016/B978-0-12-812491-8.00049-7
Lin, K.J., Mitchell, A.A., Yau, W.P., Louik, C., & Hernandez-Dias, S. (2012). Maternal Exposure to Amoxicillin and the Risk of Oral Clefts. Epidemiology, 23 (5), 699-705. doi: 10.1097/EDE.0b013e318258cb05
Liu, J., Li, Z., Ye, R., Ren, A., & Liu, J. Folic acid supplementation and risk for congenital limb reduction defects in China. Int J Epidemiol. 2019; 1, dyz130. doi: doi.org/10.1093/ije/dyz130
Mandelbrot, L, Kieffer, F., Sitta, R., Laurichesse-Delmas, H., Winer, N., Mesnard, L., Berrebi, A., Le Bouar, G.L., Bory, J.P., Cordier, A.G., Ville, Y., Perrotin, F., Jouannic, J.M., Biquard, F., D’Ercole, C., Houfflin-Debarge, V., Villena, I, & Thiebaut, R. (2018). Prenatal pyrimethamine + sulfadiazine vs spiramycin therapy to reduce placental transmission of toxoplasmosis: a randomized multicenter study. Am J Obstet Gynecol, 219 (4), 386. doi: 10.1016 / j.ajog.2018.05.031
Muanda, F.T., Sheehy, O., & Bérard, A. (2017). Use of antibiotics during pregnancy and the risk of major congenital malformations: a population based cohort study. British Journal of Clinical, 83 (11), 2557-2571. doi: 10.1111 / bcp.13364
Paquet, C., Yudin, M.H., & Sociedade de Obstetras e Ginecologistas do Canadá. (2013). Toxoplasmosis in pregnancy: prevention, screening and treatment. J Obstet Gynaecol Can, 35 (1), 78-81. doi: 10.1016/S1701-2163(15)31053-7
Petuco, L., Lohmann, P.M., & Marchese, C. (2020). Perfil epidemiológico das malformações fetais das regiões 29 e 30 da 16ª Coordenadoria Regional de Saúde do Estado do Rio Grande do Sul. Research, Society and Development, v. 9, n. 6, e130962702. doi: http://dx.doi.org/10.33448/rsd-v9i6.2702
Silva, J.H., Terças, A.C.P., Pinheiro, L.C.B., França, G.V.A., Atanaka, M., & Schuller-Faccini, L. (2018). Perfil das anomalias congênitas em nascidos vivos de Tangará da Serra, Mato Grosso, 2006-2016. Epidemiol Serv Saúde, 27 (3), e2018008. doi: 10.5123/s1679-49742018000300017
Um, B., Zhao, J.P., & Sheehy, O. (2015). Sertraline use during pregnancy and the risk of serious malformations. Am J Obstet Gynecol, 212 (6), 795.e1-795.e12. doi: 10.1016 / j.ajog.2015.01.034.
Um, K., Nelke, K., Pawlas, K., & Gerber, H. (2015). Risk factors involved in orofacial cleft predisposition - review. Open Med (Guerras), 10 (1), 163-75. doi: 10.1515 / med-2015-0027
Westhphal, F., Fustinoni, S.M., Pinto, V.L., Melo, P.S., & Abrahão, A.R. (2016). Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival. Einstein, 14 (3), 1-8. doi: 10.1590/S1679-45082016AO3721.
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