Drug use according to risk classification and associated factors among pregnant women: results from NISAMI cohort
DOI:
https://doi.org/10.33448/rsd-v9i12.11247Keywords:
Drug utilization; Pregnancy; Prenatal care; Brazil; Pharmacoepidemiology.Abstract
This study aimed to investigate the factors associated with drug use in pregnancy by risk categories in pregnant women from Santo Antônio de Jesus, Bahia. It is a cross-sectional cohort study with 1,091 pregnant women attended in primary health care between 2012 and 2014. Drug use during pregnancy was classified according to the FDA’s pregnancy risk classification. Prevalence ratios and respective 95% confidence intervals were adjusted by Poisson regression with robust error variance. The prevalence of drug use was more pronounced in risk categories A, B, C, D, and X, respectively. The use of safe medication was associated with education, number of prenatal consultations, and health problems after data adjustment. Age greater than 24 years, onset of prenatal care during the first trimester, and have any health problem were factors associated with the use of risk medication. Quality prenatal care is important to ensure the safe and conscious use of drugs. Furthermore, investments in continuing vocational education that promote rational antenatal drug use are needed.
References
Alema, N. M., Semagn, G., Melesse, S., Araya, E. M., Gebremedhin, H., Demsie, D. G., Asgedom, S. W., & Weldekidan, E. (2020). Patterns and determinants of prescribed drug use among pregnant women in Adigrat general hospital, northern Ethiopia: a cross-sectional study. BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-03327-7
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. Cadernos de Saúde Pública, 30(5), 1042–1056. https://doi.org/10.1590/0102-311X00172412
Barros, A. J., & Hirakata, V. N. (2003). Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Medical Research Methodology, 3(1), 21. https://doi.org/10.1186/1471-2288-3-21
Brum, L. F. da S., Pereira, P., Felicetti, L. L., & da Silveira, R. D. (2011). Utilização de medicamentos por gestantes usuárias do sistema único de saúde no município de Santa Rosa (RS, Brasil). Ciencia e Saude Coletiva, 16(5), 2435–2442. https://doi.org/10.1590/s1413-81232011000500012
Carmo, T. A., & Nitrini, S. M. O. O. (2004). Prescrições de medicamentos para gestantes: um estudo farmacoepidemiológico. Cadernos de Saúde Pública, 20(4), 1004–1013. https://doi.org/10.1590/S0102-311X2004000400015
Cleary, B. J., Butt, H., Strawbridge, J. D., Gallagher, P. J., Fahey, T., & Murphy, D. J. (2010). Medication use in early pregnancy-prevalence and determinants of use in a prospective cohort of women. Pharmacoepidemiology and Drug Safety, 19(4), 408–417. https://doi.org/10.1002/pds.1906
Costa, D. B., Coelho, H. L. L., & Santos, D. B. dos. (2017). Utilização de medicamentos antes e durante a gestação: prevalência e fatores associados. Cadernos de Saúde Pública, 33(2). https://doi.org/10.1590/0102-311x00126215
Couto, A. C., Ferreira, J. D., Pombo-de-Oliveira, M. S., & Koifman, S. (2015). Pregnancy, maternal exposure to analgesic medicines, and leukemia in Brazilian children below 2 years of age. European Journal of Cancer Prevention : The Official Journal of the European Cancer Prevention Organisation (ECP), 24(3), 245–252. https://doi.org/10.1097/CEJ.0000000000000070
Dathe, K., Hultzsch, S., Pritchard, L. W., & Schaefer, C. (2019). Risk estimation of fetal adverse effects after short-term second trimester exposure to non-steroidal anti-inflammatory drugs: a literature review. European Journal of Clinical Pharmacology. https://doi.org/10.1007/s00228-019-02712-2
Daw, J. R., Hanley, G. E., Greyson, D. L., & Morgan, S. G. (2011). Prescription drug use during pregnancy in developed countries: a systematic review. Pharmacoepidemiology and Drug Safety, 20(9), 895–902. https://doi.org/10.1002/pds.2184
Dillon, P., O’Brien, K. K., McDonnell, R., Donnelly-Swift, E., Galvin, R., Roche, A., Cronin, K., Walsh, D. R., Schelten, R., Smith, S., & Fahey, T. (2015). Prevalence of prescribing in pregnancy using the Irish primary care research network: a pilot study. BMC Pregnancy and Childbirth, 15(1), 67. https://doi.org/10.1186/s12884-015-0489-0
Feibus, K. B. (2008). FDA’s Proposed Rule for Pregnancy and Lactation Labeling: Improving maternal child health through well-informed medicine use. Journal of Medical Toxicology, 4(4), 284. https://doi.org/10.1007/BF03161214
Ferreira, V. D. O. G., Melnikov, P., & Kadri, M. C. T. (2011). Nível de entendimento de prescrições medicamentosas pediátricas em Unidades Básicas de Saúde. Revista Brasileira Saúde Materno Infantil, 11(3), 249–256.
Geib, L. T. C., Vargas Filho, E. F., Geib, D., Mesquita, D. I., & Nunes, M. L. (2007). Prevalência e determinantes maternos do consumo de medicamentos na gestação por classe de risco em mães de nascidos vivos. Cadernos de Saúde Pública, 23(10), 2351–2362. https://doi.org/10.1590/S0102-311X2007001000010
Guerra, G. C. B., Silva, A. Q. B. da, França, L. B., Assunção, P. M. C., Cabral, R. X., & Ferreira, A. A. de A. (2008). Utilização de medicamentos durante a gravidez na cidade de Natal, Rio Grande do Norte, Brasil. Revista Brasileira de Ginecologia e Obstetrícia, 30(1), 12–18. https://doi.org/10.1590/S0100-72032008000100003
Holmes, L. B. (2011). Human teratogens: Update 2010. Birth Defects Research Part A: Clinical and Molecular Teratology, 91(1), 1–7. https://doi.org/10.1002/bdra.20748
Instituto Brasileiro de Geografia e Estatística. (2011). Censo Demográfico - 2010: Características da população e dos domicílios. http://cidades.ibge.gov.br/painel/painel.php?lang=&codmun=292870&search=bahia%7Csantoantonio-de-jesus%7Cinfograficos:-dados-gerais-do-municipio
Irvine, L., Flynn, R. W. V., Libby, G., Crombie, I. K., & Evans, J. M. M. (2010). Drugs dispensed in primary care during pregnancy: A record-linkage analysis in tayside, Scotland. Drug Safety, 33(7), 593–604. https://doi.org/10.2165/11532330-000000000-00000
Kassada, D. S., Miasso, A. I., Waidman, M. A. P., Marcon, S. S., Kassada, D. S., Miasso, A. I., Waidman, M. A. P., & Marcon, S. S. (2015). Prevalence and factors associated with drug use in pregnant women assisted in primary care. Texto & Contexto - Enfermagem, 24(3), 713–721. https://doi.org/10.1590/0104-07072015002770013
Lee, E., Maneno, M. K., Smith, L., Weiss, S. R., Zuckerman, I. H., Wutoh, A. K., & Xue, Z. (2006). National patterns of medication use during pregnancy. Pharmacoepidemiology and Drug Safety, 15(8), 537–545. https://doi.org/10.1002/pds.1241
Leke, A. Z., Dolk, H., Loane, M., Casson, K., Maboh, N. M., Maeya, S. E., Dibo Ndumbe, L., Nyenti, P. B., Armstrong, O., & Etiendem, D. (2018). First trimester medication use in pregnancy in Cameroon: a multi-hospital survey. BMC Pregnancy and Childbirth, 18(450). https://doi.org/10.1186/s12884-018-2081-x
Lunardi-Maia, T., Schuelter-Trevisol, F., Galato, D., Lunardi-Maia, T., Schuelter-Trevisol, F., & Galato, D. (2014). Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso. Revista Brasileira de Ginecologia e Obstetrícia, 36(12), 541–547. https://doi.org/10.1590/So100-720320140005051
Maeda, S. T., & Secoli, S. R. (2008). Use and cost of medication in low risk pregnant women. 16(2).
Molla, F., Assen, A., Abrha, S., Masresha, B., Gashaw, A., Wondimu, A., Belete, Y., & Melkam, W. (2017). Prescription drug use during pregnancy in Southern Tigray region, North Ethiopia. BMC Pregnancy and Childbirth, 17(1), 170. https://doi.org/10.1186/s12884-017-1359-8
Mosha, D., Mazuguni, F., Mrema, S., Abdulla, S., & Genton, B. (2014). Medication exposure during pregnancy: a pilot pharmacovigilance system using health and demographic surveillance platform. BMC Pregnancy and Childbirth, 14(1), 322. https://doi.org/10.1186/1471-2393-14-322
Narayan, B., & Nelson-Piercy, C. (2017). Medical problems in pregnancy. Clinical Medicine, 17(3), 251–257.
Nordeng, H., Eskild, A., Nesheim, B.-I., Aursnes, I., & Jacobsen, G. (2001). Drug use during early pregnancy. European Journal of Clinical Pharmacology, 57(3), 259–263. https://doi.org/10.1007/s002280100304
Odalovic, M., Vezmar Kovacevic, S., Ilic, K., Sabo, A., & Tasic, L. (2012). Drug use before and during pregnancy in Serbia. International Journal of Clinical Pharmacy, 34(5), 719–727. https://doi.org/10.1007/s11096-012-9665-8
Osorio-de-Castro, C. G. S., Paumgartten, F. J. R., & Silver, L. D. (2004). O uso de medicamentos na gravidez. Ciência & Saúde Coletiva, 9(4), 987–996. https://doi.org/10.1590/S1413-81232004000400019
Paumgartten, Francisco J. R.. (1993). Risk assessment for chemical substances: the link between toxicology and public health. Cadernos de Saúde Pública, 9(4), 439-447. https://doi.org/10.1590/S0102-311X1993000400004
Saccone, G., Schoen, C., Franasiak, J. M., Scott, R. T., & Berghella, V. (2017). Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: a systematic review and meta-analysis of randomized, controlled trials. Fertility and Sterility, 107(2), 430-438.e3. https://doi.org/10.1016/j.fertnstert.2016.10.031
Stanley, A. Y., Durham, C. O., Sterrett, J. J., & Wallace, J. B. (2019). Safety of Over-the-Counter Medications in Pregnancy. MCN, The American Journal of Maternal/Child Nursing, 44(4), 196–205. https://doi.org/10.1097/NMC.0000000000000537
Toda, K. (2017). Is acetaminophen safe in pregnancy? Scandinavian Journal of Pain, 17(1), 445–446. https://doi.org/10.1016/j.sjpain.2017.09.007
Yang, T., Walker, M. C., Krewski, D., Yang, Q., Nimrod, C., Garner, P., Fraser, W., Olatunbosun, O., & Wen, S. W. (2008). Maternal characteristics associated with pregnancy exposure to FDA category C, D, and X drugs in a Canadian population. Pharmacoepidemiology and Drug Safety, 17(3), 270–277. https://doi.org/10.1002/pds.1538
Zhang, J., Ung, C. O. L., Guan, X., & Shi, L. (2019). Safety of medication use during pregnancy in mainland China: Based on a national health insurance database in 2015. BMC Pregnancy and Childbirth, 19(1). https://doi.org/10.1186/s12884-019-2622-y
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Copyright (c) 2020 Débora Bomfim Costa; Caroline Tianeze de Castro; Romana Santos Gama; Djanilson Barbosa dos Santos
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