Medication use and multimorbidity of non-communicable diseases during pregnancy: The 2015 Pelotas (Brazil) Birth Cohort Study

Purpose: Non-communicable diseases (NCDs) contribute to high-risk pregnancies, and medications are widely prescribed during this period. The present study aimed to describe the medication used for the following pre- and during-pregnancy NCDs: hypertensive disorders, diabetes, mental health problems (depression/anxiety), and respiratory diseases (asthma/bronchitis) among pregnant women. NCD multimorbidity and the simultaneity of NCD risk factors (alcohol consumption, smoking, physical inactivity, and overweight/obesity) according to sociodemographic and health variables were analyzed. Methods: We used data from the 2015 Pelotas Birth Cohort. Medications were classified using the Anatomical Therapeutic Chemical classification recommended by the World Health Organization for each NCD according to pregnancy trimesters. NCD multimorbidity was defined as two or more diseases that occurred before and during pregnancy. Results: The prevalence of NCD multimorbidity was 2.4% (CI95% 1.9-2.9). Considering all four NCDs, the frequency of medication used for NCD treatment was 13.5% (CI95% 12.5-14.6). More than half of the sample (54.3%) presented two or more NCD risk factors. Multimorbidity was higher among black-skinned women in the lowest income quintiles and the lowest level of education. Also, multimorbidity was higher among women who attended fewer antenatal care consultations and who had a hospitalization during pregnancy. Medication use for NCD treatment was higher among women with NCD multimorbidity, and the frequency of NCD multimorbidity was higher in women who had two or more risk factors. Conclusion: These findings may be attributed to socioeconomic inequalities. Understanding NCD multimorbidity during pregnancy supports healthcare policies and helps to unveil health inequalities.