Prévalence de l’utilisation des anti-inflammatoires non stéroïdiens chez les femmes enceintes à Lubumbashi (République Démocratique du Congo)

Abstract

Malgré l'importance de leurs effets secondaires sur la femme enceinte et le fœtus, les anti-inflammatoires non stéroïdiens (AINS) continuent à être largement utilisés par les femmes enceintes. Leur rapport bénéfice-risque n'est pas toujours bien évalué en pratique courante. L'objectif de ce travail est d’évaluer l'usage des AINS chez la femme enceinte, de discuter les risques potentiels encourus aussi bien par la mère que par le fœtus, et enfin d'en tirer des recommandations éventuelles à la femme enceinte. Du 22 août au 11 septembre 2012, une enquête a été menée auprès de 145 femmes enceintes suivies en consultation prénatale à l'Hôpital Sendwe. Un formulaire reprenant les informations sur les AINS consommés a été remis à chacune d'elle. Les résultats montrent que 75% des femmes interrogées reconnaissent avoir consommé des AINS surtout en automédication et principalement pendant les deux derniers trimestres de la grossesse pour soulager des douleurs d'origines diverses. Cette étude montre que des efforts restent encore à déployer à Lubumbashi afin de combattre l'utilisation des AINS surtout en automédication chez la femme enceinte.

Self-medication practice among pregnant women in Brazzaville

“…The study found that the self-medication practice among pregnant women was high (44,41%), which is consistent with a previous study showing high satisfaction elsewhere in sub-Saharan Africa. [15][16][17][18] In our study, there were no difference in terms of age, matrimonial status, education, gestation age, history of pregnancies and parity between pregnant women that reported self-medication and those without self-medication. However, the proportion of women with a history of self-medication was higher among women who reported self-medication practice than among women who did not practice.…”

“…19 This is the case of drugs contraindicated during fetal life and with mandatory prescription: chloramphenicol, doxicycline, and especially drugs prohibited during pregnancy, non-steroidal anti-inflammatory drugs, diclofenac or ibuprofen used by 24,3% pregnant women of this study and by 75% in Lubumbashi in the Democratic Republic of Congo. 15 This is also the case with cotrimoxazole, and mebendazole (taken because of nausea corresponding to minor ailments of pregnancy often transient). Both of these drugs are very potentially responsible for heart defects, genitourinary malformations and bicycle-palatal clefts in the foetus.…”

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] Other characteristics have been identified: the gestational age, 18 occupation, [7][8][9][10][11][12][13][14][15][16][17][18] education. [7][8][9][10][11][12][13][14][15][16][17][18][19] But, after adjustment, occupation and education were found associated with self-medication. 18 This corresponds to "diploma effect" reported by Raynaud 8 .…”

“…14 It has no known teratogenic or fetotoxic effects. [14][15][16][17][18][19][20] However, its use at doses above four grams may cause maternal or fetal liver damage. 20,21 The use of drugs by pregnant women can be harmful to the mother: this is the case for chloramphenicol, taken as self-medication by nine pregnant women to treat without diagnostic arguments what were probably malaria attacks.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18] For example, in a study conducted among 145 pregnant women followed by prenatal consultations in Democratic Republic of Congo, 75% reported use of non steriodic anti-inflammatory in selfmedication and mainly during the last two trimesters of pregnancy to treat pain from various causes. 15 In another study conducted in Ethiopia, 510 pregnant women were included and 25.1% reported self-medication. In this study, Self medication during pregnancy was significantly associated with gravid, maternal illness on the date of interview and location of health facility.…”