Morbidity and drug utilization pattern among admitted pregnant anemic women and to find out rationality of drug by using Indian guidelines

Abstract

INTRODUCTIONAnemia is the most common nutritional deficiency disease among the world. World Health Organization (WHO) has presumed that prevalence of anemia in developed and developing countries in pregnant women is 14% in developed and 51% in developing countries and 65-75% in India.1 About one-third of the global populations are anemic. 2Prevalence of anemia is higher in India when compared with other developing countries. 2 Among the Asian countries, India has the highest prevalence of anemia. About half of the global maternal deaths due to anemia occur in South Asian countries; India contributes to about 80% of the maternal deaths due to anemia. 3In India, the prevalence of anemia is high because of poor diet intake, less iron (<20 mg/day) and folic acid intake (<70 mg/day); poor bioavailability of iron (3%) in diet; and infection like hookworm infestations and malaria. 4,5 Poor iron stores at birth, low iron content of breast milk and low dietary iron intake through infancy and childhood results in high prevalence of anemia in childhood. 6 Women with mild anemia in pregnancy have decreased work capacity. Premature births are more common in women with moderate anemia. Three distinct stages of severe anemia -compensated, decompensated, and that associated with circulatory failure. Cardiac decompensation usually ABSTRACT Background: Pregnancy represents a special physiological state during which the use of drug is of growing concern due to risk of teratogenicity. Anemia is common threat to mother. Therefore, our aim was to study the drug utilization, teratogenic risk among patients of anemia in pregnancy and check rationality of prescriptions. Methods: An observational, prospective study was carried out in 150 indoor patients in the tertiary care hospital. Protocol was approved by the Institutional Review Board. The data were collected in a pre-designed proforma. Data were analyzed using SPSS version 20.0 Software. Results: Among 150 patients, 23, 111, and 16 were of <20, 20-30 and more than 30 years of age respectively. Among anemic patients Pregnancy induced hypertension (18.7%), antepartum hemorrhage (12.7%) were common. About 71% women have complaint of weakness, followed by headache. Iron (93.3%) and calcium (86.0%) were the most common drugs prescribed. Iron sucrose and packed cell volume given in severe anemia. Drug risk category, Category A (90.21%) was most frequently prescribed, which is followed by Category B (8.0%) and Category C (1.8%). Percentage of drugs prescribed by generic name and from essential drug list was 70.3 and 89.2. Overall prescribing habit was rational according to Indian guideline. Conclusion: Iron, calcium, and folic acid were most commonly prescribed drugs in anemic patients. No teratogenic risk was found out during drug use. Drug and dose of the drug was rational and appropriate. There is lesser number of drugs prescribed by generic name and hospital supply.

Study of analgesics usage in third trimester of pregnancy and its ill effects on pregnancy course and outcome

“…1 Pregnancy care is one of the greatest challenges in medicine as it demands a special care in the use of drugs because of altered physiology. 2,3 At least 10 percent of birth defects are thought to result from maternal drug exposures.…”