Profile of medication use during pregnancy: Results of the BRISA study, São Luís - MA, Brazil
DOI:
https://doi.org/10.33448/rsd-v11i2.24986Keywords:
Pharmaceutical Preparations; Pregnancy; Descriptive; Epidemiology; Prevalence.Abstract
Objectives: To describe the medication profile used during pregnancy in a Brazilian capital. Methods: Descriptive cross-sectional study with data from BRISA study in São Luís, Maranhão. Participants were interviewed in hospitals and maternity hospitals after delivery and were asked about the use of medications during pregnancy. The drugs were classified according the Anatomical Therapeutic Chemical Classification and risk categories of the Food and Drug Administration. Results: 5,110 puerperal women were interviewed, of which 93.5% reported the use of at least one medication during pregnancy. The most frequent medications were: antianemic preparations (ferrous sulfate: 72.2%; iron and multivitamins: 4.9%, folic acid: 62.9% and associations with folic acid: 6.7%), vitamins (multivitamins and others minerals: 30.3%), analgesics (paracetamol: 12.3%), antibacterials for systemic use (cephalexin: 5.6%), antiemetics and anti-nauseating agents (scopolamine butylbromide: 5.4%) and antihypertensives (methyldopa): 3.6%). Among the drugs reported: 74.5% were from category A, 18.9% from category B, 5.5% from category C, 1.0% from category D and 0.1% from category X. Conclusions: Despite, the higher prevalence of medication use during pregnancy, most of which are considered safe in pregnancy. However, it is important that the use of drugs during pregnancy is monitored and guided by health professionals in order to ensure its rational use.
References
Abraham, C., Meirowitz, N., & Kohn, N. (2014). Labor induction for premature rupture of membranes using vaginal misoprostol versus dinoprostone vaginal insert. Am J Perinatol. 3: 181-6.
Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada – RDC n° 17, de 16 de abril de 2010, dispõe sobre Boas Práticas de fabricação de Medicamentos. Diário Oficial da União, Poder Executivo, Brasília, DF, 17 de abril de 2010. http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0060_17_12_2010.html
Barbero, P., Liascovich, R., Valdez, R., & Moresco, A. (2011). Misoprostol teratogenicity: a prospective study in Argentina. Arch Argent Pediatr. 109: 226-31.
Bérard, A., Abbas-Chorfa, F., Kassai, B., Vial, T., Nguyen, K. A., Sheehy, O., & Schott, A. M. (2019). The French Pregnancy Cohort: Medication use during pregnancy in the French population. PloS one. 14: e0219095.
Brasil. Programa Nacional de Suplementação de Ferro: Manual de condutas gerais. Brasília: Ministério da Saúde, 2013. 24 p. [acesso em 12 mar 2021]. http://bvsms.saude.gov.br/bvs/publicacoes/manual_suplementacao_ferro_condutas_gerais.pdf
Brum, L. F. D. S., Pereira, P., Felicetti, L. L., & Silveira, R. D. D. (2011) Utilização de medicamentos por gestantes usuárias do Sistema Único de Saúde no município de Santa Rosa (RS, Brasil). Cien Saude Colet. 16: 2435-42.
Chan, M., Wong, I. C. K., & Sutcliffe, A. G. (2012) Prescription drug use in pregnancy: more evidence of safety is needed. TOG. 2: 87-92.
Costa, D. B., Coelho, H. L. L., & Santos, D. B. D. (2017) Utilização de medicamentos antes e durante a gestação: prevalência e fatores associados. Cad Saude Publica. 33: e00126215.
Dal Pizzol, T. S., Sanseverino, M. T. V., & Mengue, S. S. (2008) Exposure to misoprostol and hormones during pregnancy and risk of congenital anomalies Cad Saude Publica. 24: 1447-53
Dal Pizzol, T. S., Schüler-Faccini, L., Mengue, S. S., & Fischer, M. I. (2009) Dipyrone use during pregnancy and adverse perinatal events. Arch Gynecol Obstet. 279: 293-7.
Datasus. População residente - Estudo de estimativas populacionais por município, idade e sexo 2000-2015 – Brasil. 2010. http://tabnet.datasus.gov.br/cgi/deftohtm.exe?novapop/cnv/popbr.def
Diniz, D., & Castro, R. (2011) O comércio de medicamentos de gênero na mídia impressa brasileira. Cad Saude Publica. 27: 94-102.
Escumalha, M., Gouveia, C., Cunha, M., Vale, F., & Machado, M. C. (2005) Neonatal morbidity and outcome of live born premature babies after attempted illegal abortion with misoprostol. Pediatr Nurs. 31: 228-31.
Fontoura, A., Ayres, L. R., Martins-Nagai, M., Dewulf, N. L., Santos, V., Martinez, E. Z., & Pereira, L. R. (2014) Prevalence of medication use among low risk pregnant women: a drug utilization study. Afr J Pharm Pharmacol 8:883-92.
Food and Drug Administration. Highlights of Prescribing Information. 2010. https://www.fda.gov/media/96632/download
Frederiksen, M. C. (2011) The new FDA pregnancy labeling requirements for drugs. J Midwifery Womens Health. 56: 303-7.
Hoeltzenbein, M., Beck, E., Fietz, A. K., Wernicke, J., Zinke, S., Kayser, A., Padberg, S., Weber-Schoendorfer, C., Meister, R., & Schaefer, C. (2017) Pregnancy Outcome After First Trimester Use of Methyldopa: A Prospective Cohort Study. Hypertension. 70: 201-8.
Lynch, M. M., Squiers, L. B., Kosa, K. M., Dolina, S., Read, J. G., Broussard, C. S., Frey, M. T., Polen, K. N., Lind, J. N., Gilboa, S. M., & Biermann, J. (2018) Making decisions about medication use during pregnancy: Implications for communication strategies. Matern Child Health J. 22:92-100.
Mcbride, W. G. (1961) Thalidomide and congenital malformations. Lancet. 1358: 90927-8.
Melo, S. C. C. S., Pelloso, S. M., Carvalho, M. D. B., & Oliveira, N. L. B. (2009) Uso de medicamentos por gestantes usuárias do Sistema único de Saúde. Acta Paul Enferm 22: 66-70.
Mitchell, A. A., Gilboa, S. M., Werler, M. M., Kelley, K. E., Louik, C., & Hernandez-Diaz, S. (2011) National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol. 205: e1-e8.
Organização Mundial de Saúde. Diretriz: Suplementação diária de ferro e ácido fólico em gestantes. Genebra: Organização Mundial da Saúde; 2013. http://189.28.128.100/dab/docs/portaldab/documentos/guia_gestantes.pdf
Puffer, R. R., & Serrano, C. (1987) Patterns of birth weight. Washington (DC): PAHO; (Scientific Publication, 504).
Rebordosa, C., Zelop, C. M., Kogevinas, M., Sørensen, H. T., & Olsen, J. (2010) Use of acetaminophen during pregnancy and risk of preeclampsia, hypertensive and vascular disorders: a birth cohort study. J Matern Fetal Neonatal Med. 23: 371-8.
Silva, A. S. D., Maciel, G. D. A., Wanderley, L. S. D. L., & Wanderley, A. G. (2018) Indicadores do uso de medicamentos na atenção primária de saúde: uma revisão sistemática. Rev Panam Salud Publica. 2018; 41: e132.
Toda, K. (2017) Is acetaminophen safe in pregnancy? Scand J Pain 17: 445-6.
Vauzelle, C., Beghin, D., Cournot, M. P., & Elefant, E. (2013) Birth defects after exposure to misoprostol in the first trimester of pregnancy: prospective follow-up study. Reprod Toxicol. 36: 98-103.
Vidal, A. C., Murphy, S. K., Murtha, A. P., Schildkraut, J. M., Soubry, A., Huang, Z., Neelon, S. E. B., Fuemmeler, B., Iversen, E., Wang, F., Kurtzberg, J., Jirtle, R. L., & Hoyo, C. (2013) Associations between antibiotic exposure during pregnancy, birth weight and aberrant methylation at imprinted genes among offspring. Int J Obes. 37: 907-13.
World Health Organization. ATC/DDD Index 2021. Collaborating Centre for Drug Statistics Methodology: Oslo, Norway. https://www.whocc.no/atc_ddd_index/
Zhang, J., Ung, C. O. L., Wagner, A. K., Guan, X., & Shi, L. (2019) Medication use during pregnancy in Mainland China: a cross-sectional analysis of a national health insurance database. Clin Epidemiol. 11: 1057.
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Copyright (c) 2022 Renata Monteiro Lima; Joseane Lima Prado Godinho; Elma Izze da Silva Magalhães; Anaximandro Braga Brito; Maria Helena Seabra Soares de Britto; Maria Teresa Seabra Soares de Britto e Alves; Alcione Miranda dos Santos
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