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

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.