Skip to main page content
U.S. flag

An official website of the United States government

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 19:3:983131.
doi: 10.3389/fgwh.2022.983131. eCollection 2022.

Prediction and prevention of preeclampsia by physicians in Brazil: An original study

Edson Vieira da Cunha Filho  1 , Tamara Cristina Gomes Ferraz Rodrigues  2 , Valeria Cristina Sandrim  3 , Eduardo Carvalho de Arruda Veiga  2 , Ricardo Carvalho Cavalli  2
Affiliations

Prediction and prevention of preeclampsia by physicians in Brazil: An original study

Edson Vieira da Cunha Filho et al. Front Glob Womens Health. .

Abstract

Background: Considering the worldwide importance of preeclampsia, especially in Brazil, the screening of pregnant women at greater risk of developing the disease and the application of preventive measures are essential. This study aimed to assess the medical performance in this context in Brazil.

Methods: A survey was developed to quantify the number of physicians who prescribe acetylsalicylic acid (ASA) and/or calcium for preeclampsia prevention. The survey was sent to all Brazilian obstetricians affiliated to the Brazilian Federation of OBGYN by email and WhatsApp. The survey remained opened for 6 months and included questions about the use of ASA and calcium, as well as about the use of a complementary test to predict preeclampsia.

Results: The sample consisted of 360 responding physicians and 100% coverage of responses from physicians from the five different regions of Brazil was obtained. The vast majority of respondents (94.72%) prescribe ASA to prevent preeclampsia, with 80.3% prescribing a dose of 100 mg/day. Calcium is prescribed by 83.9% of the respondents. The majority of the interviewed sample (58.6%) requests uterine artery Doppler imaging to predict preeclampsia and 31.7% do not request any additional test. When the analysis was performed by region, only the northern region differed from the other Brazilian regions regarding the use of ASA and calcium for preeclampsia prevention. While more than 90% of physicians in the other regions prescribe ASA, 40% in the northern region do not use it (p < 0.0001). Regarding calcium, 30% of physicians in northern Brazil do not use the drug for preeclampsia prevention, a percentage that also differs from the other regions where the medication is prescribed by 80 to 90% of physicians (p = 0.021).

Conclusions: The vast majority of Brazilian physicians prescribe low-dose aspirin and calcium carbonate to prevent preeclampsia in high-risk pregnant women. In addition to the identification of clinical risk factors, most doctors use Doppler of the uterine arteries as a predictive method. In the northern region of Brazil, physicians use aspirin and calcium less frequently for preventing preeclampsia compared to the rest of the country.

Keywords: aspirin; calcium; prediction; preeclampsia; prevention; uterine artery Doppler.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of the sample of responding physicians by Brazilian region.
Figure 2
Figure 2
Time of discontinuation of acetylsalicylic acid use for preeclampsia prevention during pregnancy.
Figure 3
Figure 3
Time of day recommended by the respondents for acetylsalicylic acid use.
Figure 4
Figure 4
Use of calcium for preeclampsia prevention.
Figure 5
Figure 5
Medications other than acetylsalicylic acid and/or calcium prescribed by the respondents for preeclampsia prevention.
Figure 6
Figure 6
Reason for the indication of acetylsalicylic acid for preeclampsia prevention.
Figure 7
Figure 7
Tests requested for the prediction of preeclampsia by the population studied.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Magge LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, et al. . The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. (2022) 27:148–69. 10.1016/j.preghy.2021.09.008 - DOI - PubMed
    1. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. (2009) 33:130–7. 10.1053/j.semperi.2009.02.010 - DOI - PubMed
    1. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Saude e Vigilância de Doenças Não Transmissíveis. Painel de monitoramento da mortalidade materna. (2019). Available online at: http://svs.aids.gov.br/dantps/centrais-de-conteudos/paineis-de-monitora-... (accessed December 10, 2019).
    1. Passini R, Jr, Tedesco RP, Marba ST, Cecatti JG, Guinsburg R, Martinez FE, et al. . Brazilian network of studies on reproductive and perinatal health. Brazilian multicenter study on prevalence of preterm birth and associated factors. BMC Preg Childbirth. (2010) 10:22. 10.1186/1471-2393-10-22 - DOI - PMC - PubMed
    1. Souza RT, Cecatti JG, Passini R, Jr, Tedesco RP, Lajos GJ, Nomura ML, et al. . Brazilian multicenter study on preterm birth study group. The burden of provider-initiated preterm birth and associated factors: evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP). PLoS ONE. (2016) 11:e0148244. 10.1371/journal.pone.0148244 - DOI - PMC - PubMed

LinkOut - more resources