Profile of high-risk pregnant women and prescription of medications during prenatal care, hospitalization for childbirth and postpartum
DOI:
https://doi.org/10.30968/jhphs.2025.163.1356Abstract
Objective: To describe the clinical, sociodemographic and medication use profile of high-risk pregnant women followed during prenatal care, hospitalization for delivery, and immediate postpartum. Methods: This is a descriptive, retrospective, cross-sectional study, covering high-risk pregnant women at a high-risk prenatal clinic between September 2021 and March 2022. The data collected included age, clinical and reproductive history, use of medications, tobacco, alcohol, or illicit drugs during pregnancy, delivery, and postpartum, clinical complications, and hospitalization during pregnancy, and analyzing them through descriptive statistics. Results: We analyzed 312 pregnant women, with a mean age of 25.6 years (SD = 7.9), elementary to incomplete high school (61.5%), multigravida (58%), unplanned pregnancy (69.2%) and previous psychiatric disorder (17.9%). The majority (80%) presented clinical complications during pregnancy, with gestational diabetes being prevalent (37.8%). During prenatal care, 22.8% required hospitalization due to preeclampsia (5.1%), glycemic control (4.8%), and pyelonephritis (3.5%). All women used medications during pregnancy; excluding folic acid and ferrous sulfate, the percentage was 96.1%. On average, 9.25 medications (SD=6.06) were prescribed during prenatal care, 11.06 (SD=4.01) during hospitalization, and 8.98 (SD=3.2) during the postpartum period. The most prescribed medications during prenatal care were ferrous sulfate and NPH insulin; during hospitalization for delivery, oxytocin and dipyrone; and during the postpartum period, metoclopramide and acetaminophen. Conclusion: The high use of medications may be related to health conditions of pregnant women, which, if left untreated, pose risks to the mother and fetus. The treatments used are following the literature.
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Secretaria de Atenção Básica à Saúde. Nota técnica para organização da rede de atenção à saúde com foco na atenção primária à saúde e na atenção ambulatorial especializada: saúde da mulher na gestação, parto e puerpério. São Paulo: Ministério da Saúde;2019.
Ministério da Saúde. Manual de Gestação de Alto Risco. Brasília: Editora do Ministério da Saúde; 2022.
Galato D, Schraiber RB, Lunardi SS, et al. Perfil do uso de medicamentos durante a gravidez de puérperas internadas em um hospital do Brasil. Rev Bras Farm Hosp Serv Saude. 2015;6(1):24-29.
Lupattelli A, Spigset O, Twigg MJ, et al. Medication use in pregnancy: a cross-sectional, multinational web-based study. BMJ Open. 2014;4(2):e004365. doi:10.1136/bmjopen-2013-004365
Blotière PO, Damase-Michel C, Weill A, et al. Dispensing of Potentially Harmful Prescription Drugs in 1.8 Million Pregnant Women in France: A Nationwide Study Based on Two Risk Classification Systems. Drug Saf. 2021;44(12):1323-1339. doi:10.1007/s40264-021-01117-4
Fonseca MR, Fonseca Ed, Bergsten-Mendes G. Prevalência do uso de medicamentos na gravidez: uma abordagem farmacoepidemiológica. Rev Saude Publica. 2002;36(2):205-212. doi:10.1590/s0034-89102002000200013
Ministério da Saúde. Caderno dos programas nacionais de suplementação de micronutrientes. Brasília: Ministério da Saúde; 2023.
Santos SLF, Alves HHS, Barros KBNT. Avaliação dos indicadores de prescrição em gestantes de alto risco de um serviço de referência. Rev Bras Farm Hosp Serv Saúde. 2018;8(4):25-30. doi: 10.30968/rbfhss.2017.084.005
Araújo DD, Leal MM, Santos EJV, et al. Consumption of medicines in high-risk pregnancy: evaluation of determinants related to the use of prescription drugs and self-medication. Braz J Pharm Sci. 2013;49:491–9. doi: 10.1590/S1984-82502013000300010
Pereira G, Surita FG, Ferracini AC, et al. Self-Medication Among Pregnant Women: Prevalence and Associated Factors. Front Pharmacol. 2021;12:659503. doi:10.3389/fphar.2021.659503
Perini E, Magalhães SM, Noronha V. Consumo de medicamentos no período de internação para o parto. Rev Saude Publica. 2005;39(3):358-365. doi:10.1590/s0034-89102005000300005
Silveira MPT, Miranda VIA, Silveira MFD, et al. Drug use in delivery hospitalization: Pelotas births cohort, 2015. Rev Saude Publica. 2019;53:51. doi:10.11606/S1518-8787.2019053000913
Burkey BW, Holmes AP. Evaluating medication use in pregnancy and lactation: what every pharmacist should know. J Pediatr Pharmacol Ther. 2013;18(3):247-258. doi:10.5863/1551-6776-18.3.247
Leal LF, Grandi SM, Miranda VIA, et al. Hypertensive Disorders of Pregnancy and Medication Use in the 2015 Pelotas (Brazil) Birth Cohort Study. Int J Environ Res Public Health. 2020;17(22):8541. doi:10.3390/ijerph17228541
Cavalcante NCN, Simões VMF, Ribeiro MRC, et al. Maternal socioeconomic factors and adverse perinatal outcomes in two birth cohorts, 1997/98 and 2010, in São Luís, Brazil. Rev Bras Epidemiol. 2017;20(4):676-687. doi:10.1590/1980-5497201700040010
Aquino PTD, Souto BGA. High risk gestational problems common in primary care. Rev Médica Minas Gerais. 2015;v(25):568–76. doi: 10.5935/2238-3182.20150124
Coelho R, Mrejen M, Remédios J, et al. Desigualdades raciais na saúde: cuidados pré-natais e mortalidade materna no Brasil, 2014–2020. São Paulo: Instituto de Estudos para Políticas de Saúde (IEPS);2022.
Tavella RA, DE Abreu VOM, Muccillo-Baisch AL, et al. Prevalence of Illicit Drug Use During Pregnancy: A Global Perspective. An Acad Bras Cienc. 2020;92(4):e20200302. doi:10.1590/0001-3765202020200302
Nelson HD, Darney BG, Ahrens K, et al. Associations of Unintended Pregnancy With Maternal and Infant Health Outcomes: A Systematic Review and Meta-analysis. JAMA. 2022;328(17):1714-1729. doi:10.1001/jama.2022.19097
Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-e333. doi:10.1016/S2214-109X(14)70227-X
Ives CW, Sinkey R, Rajapreyar I, et al. Preeclampsia-Pathophysiology and Clinical Presentations: JACC State-ofthe-Art Review. J Am Coll Cardiol. 2020;76(14):1690-1702. doi:10.1016/j.jacc.2020.08.014
Duley L, Henderson-Smart DJ, Meher S, et al. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007;(2):CD004659. doi:10.1002/14651858.CD004659.pub2
Freitas ICS, Hintz MC, Orth LC, et al. Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes. Comparação de desfechos maternos e fetais entre parturientes com e sem o diagnóstico de diabetes gestacional. Rev Bras Ginecol Obstet. 2019;41(11):647-653. doi:10.1055/s-0039-1696947
Guedes HM, Sousa AA, Barbosa BR, et al. Gestação de alto risco: perfil epidemiológico e fatores associados com o encaminhamento para serviço especializado. Rev Enferm Cent-Oeste Min. 2022;v(12):4219. doi:10.19175/recom.v12i0.4219
Nagai MM, Ayres LR, Zanetti MOB, et al. Gestação de alto risco: caracterização do perfil de utilização de medicamentos e associação com fatores clínicos e sociodemográficos. Rev Bras Saúde Materno Infant. 2022;v(22):619–29. doi: 10.1590/1806-9304202200030010
Basso NADS, Costa RAA, Magalhães CG, et al. Insulinoterapia, controle glicêmico materno e prognóstico perinatal: diferença entre o diabetes gestacional e o clínico. Rev Bras Ginecol E Obstetrícia. 2007;29(5). doi: 10.1590/S0100-72032007000500006
Ramos VM, Figueiredo EN, Succi RC. Barriers to control syphilis and HIV vertical transmission in the health care system in the city of Sao Paulo. Rev Bras Epidemiol. 2014;17(4):887-898. doi:10.1590/1809-4503201400040008
Moraes AP, Barreto SM, Passos VM, et al. Incidence and main causes of severe maternal morbidity in São Luís, Maranhão, Brazil: a longitudinal study. Sao Paulo Med J. 2011;129(3):146-152. doi:10.1590/s1516-31802011000300005
Leal MDC, Bittencourt SA, Esteves-Pereira AP, et al. Progress in childbirth care in Brazil: preliminary results of two evaluation studies. Avanços na assistência ao parto no Brasil: resultados preliminares de dois estudos avaliativos. Cad Saude Publica. 2019;35(7):e00223018. doi:10.1590/0102-311X00223018
Ministério da Saúde. Secretaria de Ciência. Protocolo Clínico e Diretrizes Terapêuticas para Prevenção da Transmissão Vertical do HIV, Sífilis e Hepatites Virais. Brasília: Ministério da Saúde;2022.
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