Prescrição de medicamentos e desfechos perinatais em gestantes atendidas em um centro estadual de atenção especializada

Abstract

High-risk pregnancy is characterized by medical or obstetric conditions associated with several risks for the mother or fetus. Among relevant aspects during pregnancy is the use of medications. The indiscriminate consumption of medications is among the risk factors for maternal morbidity and mortality, and for adverse perinatal outcomes. However, the rational use could bring numerous benefits to high-risk pregnant women. This study aims to describe the clinical-epidemiological profile of high-risk pregnant women attended at a State Center for Specialized Care, a reference for 10 cities, in a micro-region in the South of Minas Gerais, as well as to characterize the prescribed medications during pregnancy monitoring and its association with adverse perinatal outcomes. Two articles will be presented with their respective study designs: 1. cross-sectional analytical; 2. case-control study, carried out with secondary data obtained through the analysis of medical records of care in the High-Risk Pregnancy and Pediatrics sectors of the Center, between 2015 and 2021. Data analysis was carried out using the Statistical Package for the Social Science (SPSS) software. Initially, the frequency distribution of all evaluated variables was performed. Bivariate analyzes were made using the Chi-Square and Mann-Whitney tests (α= 5%). Significant variables were included in a logistic regression model. The results showed a relevant percentage of chronic noncommunicable diseases (NCDs) prior to the beginning of pregnancy (46.4%) and polypharmacy (16.1%) among high-risk pregnant women. Maternal factors, such as advanced age and the presence of chronic diseases, were shown to be predictors for the prescription of high-risk medications and polypharmacy. In the case-control study, the polypharmacy was associated with Apgar scores lower than seven (OR: 4.091; 95% CI: 1.279-13.087). Knowledge of the clinical and epidemiological reality of high-risk pregnant women, and detailed information on prescription and medication consumption should be considered and encouraged by health professionals and managers. Such information is extremely valuable in supporting clinical and management practice, in addition to help to improve the evidence base for the use of medications during pregnancy and its consequent outcomes.