Avaliação do impacto das interações medicamentosas graves em gestantes hospitalizadas: relevância clínica e desfechos maternofetais

Abstract

Objective: To assess the impact of severe drug-drug interactions (DDIs) on clinical parameters and maternal-fetal outcomes in high-risk hospitalized pregnant women. Methodology: Prospective cohort study involving 571 hospitalized pregnant women from September 2019 to June 2022, with a mean age of 30.6 years, mostly diagnosed with hypertensive syndromes (69.7%) and gestational diabetes mellitus (57.1%). DDIs were characterized daily using the Lexicomp® database, and clinical parameters related to their mechanisms of action were monitored. Multivariate logistic regression models adjusted for major risk factors for DDI occurrence were used to evaluate the potential influence of severe DDIs on clinical parameters and maternal-fetal outcomes. Results: We identified 203 pregnant women with one or more severe DDIs (35.6%). Risk factors for their occurrence were gestational age (AOR: 0.958; 95% CI: 0.932-0.984), hypertension diagnosis (AOR: 3.997; 95% CI: 2.493-6.409), number of medications (AOR: 1.088; 95% CI: 1.031-1.148), and duration of treatment (AOR:1.184; 95% CI: 1.116-1.257). Concomitant use of dipyrone and acetylsalicylic acid led to increased systolic blood pressure (AOR: 2.124; 95% CI: 1.008-4.474), while patients using scopolamine and levomepromazine simultaneously experienced increased drowsiness (AOR: 5.375; 95% CI: 1.660-17.398) and slight temperature elevation (AOR: 5.956; 95% CI: 1.226- 28.982). Conclusion: Hospitalized pregnant women, especially those with lower gestational age and diagnosed with hypertensive syndromes, are exposed to severe drug-drug interactions. However, these interactions do not significantly impact maternal-fetal clinical outcomes.