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. 2024 Jun 5:17:2755-2775.
doi: 10.2147/JMDH.S455378. eCollection 2024.

Racial Disparities in Medication Use During Pregnancy: Results from the NISAMI Cohort

Caroline Tianeze de Castro  1 , Lisiane Freitas Leal  2 , Dandara de Oliveira Ramos  1 , Jerusa da Mota Santana  3 , Rosa Cândida Cordeiro  3   4 , Maria da Conceição Costa Rivemales  3   4 , Edna Maria de Araújo  5 , Carlos Alberto Lima da Silva  5 , Marcos Pereira  1 , Djanilson Barbosa Dos Santos  3   4   5
Affiliations

Racial Disparities in Medication Use During Pregnancy: Results from the NISAMI Cohort

Caroline Tianeze de Castro et al. J Multidiscip Healthc. .

Abstract

Purpose: This study aimed to evaluate racial disparities in medication use and associated factors among pregnant women receiving prenatal care at Brazilian Unified Health System primary care health units in the northeast region.

Patients and methods: A total of 1058 pregnant women in the NISAMI Cohort were interviewed between June 2012 and February 2014. Medicines used during pregnancy were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and ANVISA pregnancy risk categories. Prevalence ratios (crude and adjusted) and 95% confidence intervals (CIs) were estimated using Poisson regression with robust error variance. All analyses were stratified by race (Asian, black, brown/mixed, Brazilian indigenous, and white).

Results: Approximately 84% of the pregnant women used at least one medication, with a lower proportion among white women. The most reported medications were antianemic preparations (71.08%; 95% CI 68.27-73.72%), analgesics (21.74%; 95% CI 19.36-24.32%), and drugs for functional gastrointestinal disorders (18.81%; 95% CI 16.57-21.28%). Approximately 29% of women took potentially risky medications during pregnancy, with a higher prevalence among Asian and white women. Factors associated with medication use during pregnancy include a greater number of prenatal consultations, higher education levels, health problems, and smoking. In addition, maternal age above 25 years, smoking status, and two or more previous pregnancies were associated with potentially risky medication use during pregnancy.

Conclusion: A high prevalence of medication use during pregnancy was found; however, this prevalence was lower among white women. Nonetheless, black and brown women used antianemic preparations less frequently. This finding suggests that race is a factor of inequity in prenatal care, demanding public policies to mitigate it.

Keywords: cohort studies; drug utilization; pharmacoepidemiology; pregnancy; racial groups.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Percentage of patients who used medication during pregnancy by race. NISAMI Cohort Study, Brazil, 2012–2014 (n = 1058).
Figure 3
Figure 3
Percentage of the top medication classes taken during pregnancy by race. NISAMI Cohort Study, Brazil, 2012–2014 (n = 892).
Figure 4
Figure 4
Percentage of potentially risky medication use during pregnancy by race. NISAMI Cohort Study, Brazil, 2012–2014 (n = 261).
See this image and copyright information in PMC

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References

    1. Stanley AY, Durham CO, Sterrett JJ, Wallace JB. Safety of over-the-counter medications in pregnancy. MCN Am J Matern Nurs. 2019;44(4):196. doi:10.1097/NMC.0000000000000537 - DOI - PubMed
    1. Lunardi-Maia T, Schuelter-Trevisol F, Galato D. Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso. Rev Bras Ginecol E Obstetrícia. 2014;36(12):541–547. doi:10.1590/So100-720320140005051 - DOI - PubMed
    1. Smolina K, Hanley GE, Mintzes B, Oberlander TF, Morgan S, Fischer G. Trends and determinants of prescription drug use during pregnancy and postpartum in british columbia, 2002–2011: a population-based cohort study. PLoS One. 2015;10(5):e0128312. doi:10.1371/journal.pone.0128312 - DOI - PMC - PubMed
    1. Costa DB, Coelho HLL, Santos DB. Utilização de medicamentos antes e durante a gestação: prevalência e fatores associados. Cad Saúde Pública. 2017;33:e00126215. doi:10.1590/0102-311X00126215 - DOI - PubMed
    1. Engeland A, Bjørge T, Klungsøyr K, Hjellvik V, Skurtveit S, Furu K. Trends in prescription drug use during pregnancy and postpartum in Norway, 2005 to 2015. Pharmacoepidemiol Drug Saf. 2018;27(9):995–1004. doi:10.1002/pds.4577 - DOI - PubMed