Evaluation of the Use of Anti-Inflammatory, Analgesics, and Antipyretics during Pregnancy: A Population Cohort Study in a Capital City of the North Region of Brazil
Andréia Moreira de Andrade
Post-Graduation Program at Federal University of Acre, Rio Branco, Acre, Brazil.
João Rafael Valentim-Silva *
University of Vassouras, Saquarema, Federal University of Santa Catarina, Santa Catarina, Education and Technology College of Amazon, Pará; State University of Santa Catarina, Florianópolis, Brazil.
Alanderson Alves Ramalho
Post-Graduation Program at Federal University of Acre, Rio Branco, Acre, Brazil.
Fernanda Andrade Martins
Post-Graduation Program at Federal University of Acre, Rio Branco, Acre, Brazil.
Lydhia Rubhia de Lima Torres
Collective Health Program at Federal University of Acre, Brazil.
Rosalina Jorge Koifman
Oswaldo Cruz Foundation, and Public Health and Environment Program, Rio de Janeiro, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To analyze the use of anti-inflammatory drugs and the associated factors, including educational level, number of prenatal visits, and food insecurity, during pregnancy.
Study Desing: Population-based cross-sectional study.
Place and Durationof Study: The sample were recruited in two maternity hospitals of Rio Branco, Acre, Brazil. The Santa Juliana Hospital and Maternity (HSJ) and the Bárbara Heliodora Maternity in April 6 and July 10, 2015
Methodology: Demographic, socioeconomic, reproductive, maternal habits, prenatal care, and newborn status were investigated. Multivariate analysis with logistic regression was performed, considering p<0.05 for association.
Results: 1190 postpartum women were interviewed. Anti-inflammatories were not used by only 13.2% of pregnant women. The prevalence of dipyrone use was 72.7%, paracetamol 50.3%, nimesulide 16.1%, and diclofenac 5.2%. Women with lower educational levels (up to high school OR=1.55, 95% CI 1.07-2.25), those who consumed alcohol (OR=1.96, 95% CI 1.03-3.73), and those with a higher number of living children (more than 4 children OR=1.6, 95% CI 1.06-2.24, 2 to 3 children OR=1.52, 95% CI 1.10-2.27) had a higher chance of using anti-inflammatories during pregnancy. Primiparous women (OR=0.66, 95% CI 0.47-0.93), those with more than eight prenatal visits (OR=0.55, 95% CI 0.35-0.85), and those experiencing moderate to severe food insecurity (OR=0.42, 95% CI 0.25-0.69) had a lower chance of using anti-inflammatories during pregnancy. After adjusted analysis, alcohol consumption and the number of living children lost statistical significance and were not included in the final model as independent variables.
Conclusion: The prevalence of anti-inflammatory use was high. Alternative therapies and restricting prescriptions to necessary cases could be proposed to reduce the use of non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy.
Keywords: Anti-inflamatórios, gestantes, pré-natal, pregnancy