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.
Highlights
The use of medications during pregnancy is a phenomenon that has been described by pharmacoepidemiological studies worldwide, due to its increasing prevalence and insufficient evidence about its effects on the fetus (Daw et al, 2011; Stanley et al, 2019)
In Brazil the percentage of use of drugs included in categories D and X, considered potentially teratogenic, varies from 0.3% to 3.0% (Carmo & Nitrini, 2004; Guerra et al, 2008); concerning category C, in which risk, the probability that a drug will produce adverse effects on a given population (Paumgartten, 1993), cannot be excluded, there is a variation between 17.5% and 33.6% (Brum et al, 2011; Lunardi-Maia et al, 2014)
50,00% of pregnant women had less than nine years of study, 84.70% were black, and 23.50% earned less than one minimum wage
Summary
The use of medications during pregnancy is a phenomenon that has been described by pharmacoepidemiological studies worldwide, due to its increasing prevalence and insufficient evidence about its effects on the fetus (Daw et al, 2011; Stanley et al, 2019). Due to the frequent need for drug interventions, the North American Food and Drug Administration (FDA) proposed the classification of drugs according to risk criteria, in an attempt to direct and make the prescription safer. This classification is limited and has been updated because it does not take into account an individual analysis of the drugs used during pregnancy (Andrade et al, 2014; Feibus, 2008; Holmes, 2011), it continues to be used, as few studies adopt other risk classifications, preventing comparability. In Brazil the percentage of use of drugs included in categories D and X, considered potentially teratogenic, varies from 0.3% to 3.0% (Carmo & Nitrini, 2004; Guerra et al, 2008); concerning category C, in which risk, the probability that a drug will produce adverse effects on a given population (Paumgartten, 1993), cannot be excluded, there is a variation between 17.5% and 33.6% (Brum et al, 2011; Lunardi-Maia et al, 2014)
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