Severe drug interactions in high-risk pregnant women: a network analysis

Abstract

Objective: This study aims to characterize the occurrence of Potential Drug Interactions (PDIs) in hospitalized pregnant women, main drugs involved and potential clinical outcomes via network analysis. Methods: This study received institutional research ethics committee approval and written consent. Cohort study with 297 high-risk pregnant women seen at a maternity school between August 2019 and August 2021. All patients with a hospitalization time of more than 24 h were included. Daily evaluation via interviews and electronic chart analysis. PDIs were classified using the UpToDate database into mild, moderate and severe, network analysis was done using Gephi software adopting the centrality criterion. Results: With a predominance of hypertension (32%) and gestational diabetes (35.7%), a prevalence of 85.3% and incidence of 146.3 PDI per 1000 patients (95% CI 121.5 - 198.6) were observed. Regarding severe PDI, the network analysis highlighted three drugs: levomepromazine associated with depressants and anticholinergics, dipyrone associated with NSAIDs, and ferrous sulfate with drugs with potential for its chelation. Conclusions: The prevalence of PDIs in high-risk pregnant women is high, and clinically they are related to poorer blood pressure control, anemia, anti-muscarinic effects, and central nervous system depression.