O uso e o não uso de medicamentos na gravidez: potenciais fatores de risco para o desenvolvimento de malformações congênitas
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Aug 24, 2024
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Resumo
Objetivo: Conhecer o comportamento das mulheres do estado de Roraima em relação ao uso de medicamentos durante a gestação. Métodos: Inquérito por meio de ficha epidemiológica. Resultados: Do total de 158 participantes, 37,3% gestaram crianças com malformações congênitas e 62,7% não. A média de idade (p=0,0380) juntamente com a renda familiar baixa (p=0,0259) entre os grupos foi estatisticamente significante, sendo que as mulheres na faixa etária de 13 a 25 anos (p=0,0006) possuem maior risco de apresentarem filhos com defeitos congênitos. Além do mais, a ausência de adesão materna ao tratamento medicamentoso (p=0,0260; OR: 2,727; IC: 1,156-6,434) também se associou ao desenvolvimento dessas anormalidades. No mais, o uso de analgésicos (p=0,0577; OR: 3,725; IC: 1,070-12,975) e antibióticos (p=0,0588; OR: 2,259; IC: 1,009-5,057) antes e durante o período gestacional, parece favorecer o aparecimento das malformações congênitas. Conclusão: Mulheres na faixa-etária de 13 a 25 anos de idade, com renda inferior ou igual a um salário-mínimo e que não fazem o uso de medicamentos prescritos durante a gestação, se associam ao desenvolvimento de crianças com malformações congênitas. Além disso, a utilização de analgésicos e antibióticos antes e durante o período gestacional parece favorecer o aparecimento dessas anormalidades.
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Como Citar
CardosoL. S., MesquitaK. T., SantosY. de F., SouzaD. M. de, SequeiraB. J., LinsC. D. de M., NakashimaF., LimaG. M., RibeiroL. B., & FerreiraA. I. C. (2024). O uso e o não uso de medicamentos na gravidez: potenciais fatores de risco para o desenvolvimento de malformações congênitas. Revista Eletrônica Acervo Saúde, 24(8), e15221. https://doi.org/10.25248/reas.e15221.2024
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Referências
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30. PRICE HR, COLLIER AC. Analgesics in pregnancy: an update on use, safety and pharmacokinetic changes in drug disposition. Current Pharmaceutical Design, 2017; 23: 6098-6114.
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32. SITKIN N, et al. Congenital anomalies in low- and middle-income countries: the unborn child of global surgery. World Journal of Surgery, 2015; 39: 36-40.
33. SNIJDER CA, et al. Intrauterine exposure to mild analgesics during pregnancy and the occurrence of cryptorchidism and hypospadia in the offspring: the generation r study. Human Reproduction, 2012; 27: 1191-1201.
34. TOMASI E, et al. Qualidade da atenção pré-natal na rede básica de saúde do Brasil: indicadores e desigualdades sociais. Cadernos de Saúde Pública, 2017; 33: e00195815.
35. VARGESSON N. Review thalidomide-induced teratogenesis: history and mechanisms. Birth Defects Research Part C, 2015; 105: 140-156.
36. VERMA RP. Evaluation and risk assessment of congenital anomalies in neonates. Children, 2021; 8:1-12.
37. VIELLAS EF, et al. Assistência pré-natal no Brasil. Cadernos de Saúde Pública, 2014; 30: S85-S100.
38. WANDERLEY HYC, ARTIGALÁS OAP. Analgésicos e anti-inflamatórios. In: Manual de teratogênese em humanos. Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO); 2011; 95-103.
39. WANG D, et al. Maternal periconceptional folic acid supplementation and risk for fetal congenital heart defects. The Journal of Pediatrics, 2022; 240: 72-78.
40. WILSON RD, et al. Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies. Journal of Obstetrics and Gynaecology Canada, 2015; 37: 534-549.
41. WU VK, et al. Burden of surgical congenital anomalies in Kenya: a population-based study. Journal of Tropical Pediatrics, 2013; 59: 195-202.
42. ZHANG XH, et al. Chromosomal abnormalities: subgroup analysis by maternal age and perinatal features in zhejiang province of China, 2011–2015. Italian Journal of Pediatrics, 2017; 43: 1-6.
2. ATRASH HK, et al. Preconception care for improving perinatal outcomes: the time to act. Maternal and Child Health Journal, 2006; 10: S3-S11.
3. BRANNON PM e TAYLOR CL. Iron supplementation during pregnancy and infancy: uncertainties and implications for research and policy. Nutrients, 2017; 9: 1327.
4. BRONBERG R. Birth prevalence of congenital anomalies in the City of Buenos Aires, Argentina, according to socioeconomic level. Journal of Community Genetics, 2020; 11: 303-311.
5. CABRAL RD, et al. Antimicrobianos. In: Manual de teratogênese em humanos. Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO); 2011; 45-56.
6. CARMO TA, NITRINI SMOO. Prescrições de medicamentos para gestantes: um estudo farmacoepidemiológico. Cadernos de Saúde Pública, 2004; 20: 1004-1013.
7. DEAN JH, et al. Neural tube defects and associated anomalies before and after folic acid fortification. The Journal of Pediatrics, 2020; 226: 186-194.
8. DONG J, et al. Initiation and duration of folic acid supplementation in preventing congenital malformations. BMC Medicine, 2023; 21: 1-13.
9. EMORDI VC, OSIFO DO. Challenges of congenital malformations: an African perspective. Annals of Pediatric Surgery, 2018; 14: 1-7.
10. FLEMING TP, et al. Environmental exposures around conception: developmental pathways leading to lifetime disease risk. International Journal of Environmental Research and Public Health, 2021; 18: 1-18.
11. FONTOURA FC, CARDOSO MVLML. Association between congenital malformation and neonatal and maternal variables in neonatal units of a Northeast Brazilian city. Texto & Contexto – Enfermagem, 2014; 23: 907-914.
12. FRANÇA VH, et al. A multiprofessional perspective on the principal barriers to universal health coverage and universal access to health in extremely poor territories: the contributions of nursing. Revista Latino-Americana de Enfermagem, 2016; 24: e2795.
13. GILL SK, et al. Association between maternal age and birth defects of unknown etiology - United States, 1997-2007. Birth Defects Research Part A: Clinical and Molecular Teratology. 2012; 94: 1010-1018.
14. GREEN NS. Folic acid supplementation and prevention of birth defects. Journal of Nutrition, 2002; 132: 2356S-2360S.
15. HAN JY, et al. Unintended pregnancies and exposure to potential human teratogens. Birth Defects Research Part A: Clinical and Molecular Teratology, 2005; 73: 245-248.
16. HOWSON CP, et al. Controlling birth defects: reducing the hidden toll of dying and disabled children in low-income countries. Disease Control Priorities Project, 2008.
17. JOHNSON K, et al. Centers for disease control and prevention. Recommendations to improve preconception health and health care - United States/A report of the CDC/ATSDR preconception care work group and the select panel on preconception care. MMWR 2006; 55: RR-6.
18. KAPAPA M, et al. Risk factors for abdominal wall defects. Congenital Anomalies, 2020; 60: 54-61.
19. KARAI A, et al. Adverse perinatal outcome in teenage pregnancies: an analysis of a 5-year period in Southeastern Hungary. The Journal of Maternal-Fetal & Neonatal Medicine, 2019; 32: 2376-2379.
20. KANG G, et al. Adverse effects of young maternal age on neonatal outcomes. Singapore Medical Journal, 2015; 56: 157-163.
21. MASHUDA F, et al. Pattern and factors associated with congenital anomalies among young infants admitted at Bugando medical centre, Mwanza, Tanzania. BMC Research Notes, 2014; 7: 195.
22. MALVASI A, et al. Possible long term teratogenic effect of isotretinoin in pregnancy. European Review for Medical and Pharmacological Sciences, 2009; 13: 393-396.
23. MARIO DN, et al. Qualidade do pré-natal no Brasil: pesquisa nacional de saúde 2013. Ciência & Saúde Coletiva, 2019; 24: 1223-1232.
24. MEANS RT. Iron deficiency and iron deficiency anemia: implications and impact in pregnancy, fetal development, and early childhood parameters. Nutrients, 2020; 12: 447.
25. MEDAWAR G, et al. Awareness and use of folic acid among women of childbearing age. Annals of Global Health, 2019; 85: 1-6.
26. MOORE KL, et al. Embriologia básica. 9 ed. Rio de Janeiro: Elsevier, 2016. 311p.
27. NOGUEIRA-DE-ALMEIDA CA, et al. Além da nutrição – o impacto da nutrição materna na saúde das futuras gerações. 1ª ed. São Paulo: Luiz Martins Editorial Ltda., 2019; 180p.
28. NORDENG H, et al. Perception of risk regarding the use of medications and other exposures during pregnancy. European Journal of Clinical Pharmacology, 2010; 66: 207-214.
29. OBEID R, et al. Folate supplementation for prevention of congenital heart defects and low birth weight: an update. Cardiovascular Diagnosis and Therapy, 2019; 9: S424-S43.
30. PRICE HR, COLLIER AC. Analgesics in pregnancy: an update on use, safety and pharmacokinetic changes in drug disposition. Current Pharmaceutical Design, 2017; 23: 6098-6114.
31. SILVA LKP, MARQUES AEF. Utilização de medicamentos por gestantes: uma revisão sistemática da literatura. Revista de Atenção à Saúde, 2019; 17: 90-97.
32. SITKIN N, et al. Congenital anomalies in low- and middle-income countries: the unborn child of global surgery. World Journal of Surgery, 2015; 39: 36-40.
33. SNIJDER CA, et al. Intrauterine exposure to mild analgesics during pregnancy and the occurrence of cryptorchidism and hypospadia in the offspring: the generation r study. Human Reproduction, 2012; 27: 1191-1201.
34. TOMASI E, et al. Qualidade da atenção pré-natal na rede básica de saúde do Brasil: indicadores e desigualdades sociais. Cadernos de Saúde Pública, 2017; 33: e00195815.
35. VARGESSON N. Review thalidomide-induced teratogenesis: history and mechanisms. Birth Defects Research Part C, 2015; 105: 140-156.
36. VERMA RP. Evaluation and risk assessment of congenital anomalies in neonates. Children, 2021; 8:1-12.
37. VIELLAS EF, et al. Assistência pré-natal no Brasil. Cadernos de Saúde Pública, 2014; 30: S85-S100.
38. WANDERLEY HYC, ARTIGALÁS OAP. Analgésicos e anti-inflamatórios. In: Manual de teratogênese em humanos. Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO); 2011; 95-103.
39. WANG D, et al. Maternal periconceptional folic acid supplementation and risk for fetal congenital heart defects. The Journal of Pediatrics, 2022; 240: 72-78.
40. WILSON RD, et al. Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies. Journal of Obstetrics and Gynaecology Canada, 2015; 37: 534-549.
41. WU VK, et al. Burden of surgical congenital anomalies in Kenya: a population-based study. Journal of Tropical Pediatrics, 2013; 59: 195-202.
42. ZHANG XH, et al. Chromosomal abnormalities: subgroup analysis by maternal age and perinatal features in zhejiang province of China, 2011–2015. Italian Journal of Pediatrics, 2017; 43: 1-6.