Uso de medicación en niños, desde los tres meses hasta los cuatro años de edad, en una cohorte de nacimiento de 2015 en Pelotas, Rio Grande do Sul, Brasil

Farías-Antúnez, Simone; Silveira, Marysabel Pinto Telis; Domingues, Marlos Rodrigues; Silveira, Mariângela Freitas da; Bertoldi, Andréa Dâmaso

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ARTICLE • Cad. Saúde Pública 38 (3) • 2022 • https://doi.org/10.1590/0102311X00117221 copiar

Uso de medicación en niños, desde los tres meses hasta los cuatro años de edad, en una cohorte de nacimiento de 2015 en Pelotas, Rio Grande do Sul, Brasil

Autoría SCIMAGO INSTITUTIONS RANKINGS

El consumo de medicamentos es una parte importante del proceso de salud y la prevalencia de su uso entre bebés puede llegar a un 65% durante los primeros meses de vida. El excesivo consumo de medicamentos podría conducir a un incremento en sus perjuicios potenciales frente a sus beneficios. Teniendo esto en cuenta, el objetivo de este estudio fue describir el uso de la medicación en niños de 3, 12, 24, y 48 meses. Se aplicaron cuestionarios estandarizados para evaluar los patrones de uso de la medicación y sus covariables. Se investigó el uso de la medicación como un resultado y se definió como haber recibido alguna medicación en los últimos 15 días antes de la entrevista. Se describieron la prevalencia del IC95%uso de la medicación y los intervalos de 95% de confianza (IC95%), usando tests chi-cuadrado. También se informó de la fuente de prescripción y frecuencia del consumo, junto a la medicación más frecuente en cada seguimiento. La prevalencia en el uso de la medicación fue de un 67,2% (IC95%: 65,8; 68,6), 68,2% (IC95%: 66,8; 69,6), 52,4% (IC95%: 50,9; 54,0), 47,2% (IC95%: 45,7; 48,8), a los 3, 12, 24, y 48 meses, respectivamente. Se observó una disminución en la proporción de medicamentos recetados médicamente y un incremento en la automedicación a lo largo de los años. Los medicamentos más frecuentemente usados fueron los destinados para desórdenes gastrointestinales (A03), vitaminas (A11), analgésicos (N02), antiinflamatorios (M01), y preparados nasales (R01). Descubrimos que más de un 50% del total y automedicación en el consumo de medicinas en niños menores de 4 años. Estos resultados subrayan la necesidad de avisar a los cuidadores sobre la importancia de un examen profesional apropiado y la receta antes de la administración del medicamento a niños.

Palabra-clave:
Utilización de Medicamentos; Lactante; Preescolar; Estudios Longitudinales; Cuidado del Niño

Characteristics	Medication use [OR * (95%CI)]
	3 months	12 months	24 months	48 months
	[n = 4,110]	[n = 4,018]	[n = 4,014]	[n = 4,010]
Maternal
Age (years)	p = 0.838	p = 0.189	p = 0.419	p = 0.011
< 19	1.00	1.00	1.00	1.00
20-24	0.93 (0.75; 1.16)	1.12 (0.90; 1.40)	1.16 (0.94; 1.44)	1.23 (0.99; 1.52)
25-30	0.90 (0.72; 1.13)	1.26 (1.00; 1.57)	1.16 (0.94; 1.44)	1.31 (1.06; 1.62)
> 30	0.95 (0.76; 1.19)	1.23 (0.98; 1.53)	1.07 (0.86; 1.32)	1.43 (1.16; 1.78)
Educational attainment (years)	p < 0.001	p < 0.001	p < 0.001	p = 0.030
0-4	1.00	1.00	1.00	1.00
5-8	1.02 (0.80; 1.30)	1.21 (0.95; 1.55)	1.16 (0.91; 1.47)	1.06 (0.83; 1.36)
9-12	1.27 (1.00; 1.61)	1.54 (1.21; 1.97)	1.32 (1.04; 1.66)	1.14 (0.90; 1.45)
> 12	1.92 (1.49; 2.47)	2.13 (1.65; 2.76)	1.80 (1.42; 2.29)	1.34 (1.05; 1.71)
Family income (minimum wage)	p = 0.244	p = 0.570	p = 0.219	p = 0.565
≤ 1	1.00	1.00	1.00	1.00
1.1-3.0	1.05 (0.85; 1.29)	1.06 (0.86; 1.31)	1.10 (0.90; 1.35)	1.01 (0.82; 1.24)
3.1-6.0	1.10 (0.86; 1.40)	1.04 (0.81; 1.33)	1.25 (0.99; 1.57)	0.96 (0.76; 1.21)
6.1-10.0	1.38 (0.97; 1.96)	1.34 (0.93; 1.92)	1.35 (0.98; 1.86)	1.08 (0.78; 1.49)
Skin color	p = 0.007	p = 0.096	p = 0.520	p = 0.325
White	1.00	1.00	1.00	1.00
Black	0.75 (0.62; 0.90)	0.84 (0.70; 1.00)	0.92 (0.77; 1.10)	0.92 (0.77; 1.10)
Mixed-race/Yellow/Other	0.93 (0.76; 1.13)	0.86 (0.71; 1.06)	0.92 (0.76; 1.11)	0.89 (0.73; 1.07)
Living with a partner	p = 0.018	p = 0.079	p = 0.517	p = 0.698
No	1.00	1.00	1.00	1.00
Yes	0.80 (0.65; 0.96)	1.19 (0.98; 1.44)	0.94 (0.78; 1.13)	0.94 (0.80; 1.16)
Child
Sex	p = 0.057	p = 0.001	p = 0.086	p = 0.623
Male	1.00	1.00	1.00	1.00
Female	0.88 (0.77; 1.00)	1.20 (0.70; 0.92)	0.90 (0.79; 1.02)	1.03 (0.89; 1.31)
Gestational age (weeks)	p < 0.001	p = 0.032	p = 0.552	p = 0.202
Preterm (< 37)	1.00	1.00	1.00	1.00
Early term (37-38)	0.60 (0.47; 0.75)	0.77 (0.62; 0.95)	0.97 (0.80; 1.17)	1.08 (0.90; 1.31)
Full term (39-40)	0.46 (0.37; 0.57)	0.75 (0.61; 0.93)	0.99 (0.82; 1.19)	0.93 (0.77; 1.13)
Late & post term (41-42)	0.44 (0.33; 0.59)	0.68 (0.51; 0.92)	0.83 (0.63; 1.10)	0.93 (0.71; 1.23)
Type of delivery	p = 0.190	p = 0.061	p < 0.001	p = 0.024
Vaginal	1.00	1.00	1.00	1.00
Cesarean section	1.10 (0.95; 1.27)	1.15 (0.99; 1.34)	1.29 (1.12; 1.47)	1.17 (1.02; 1.34)
Breastfeeding duration (months)	p = 0.007	p = 0.468	p = 0.276	p = 0.237
No breastfeeding	1.10 (0.90; 1.35)	0.90 (0.73; 1.10)	1.05 (0.86; 1.27)	0.95 (0.77; 1.17)
≤ 6	1.31 (1.11; 1.54)	1.05 (0.89; 1.24)	1.16 (1.00; 1.27)	1.08 (0.92; 1.25)
7-12	1.00 (0.82; 1.22)	0.95 (0.78; 1.17)	1.06 (0.88; 1.27)	1.17 (0.97; 1.41)
> 12	1.00	1.00	1.00	1.00
Maternal perception of child’s health		p < 0.001	p < 0.001	p < 0.001
Excellent	-	1.00	1.00	1.00
Very good/Good	-	1.53 (1.33; 1.76)	1.66 (1.45; 1.90)	1.60 (1.40; 1.83)
Regular/Bad	-	4.08 (2.70; 6.16)	3.99 (3.02; 5.28)	4.54 (3.39; 6.01)

Characteristics	Total cohort [n = 4,275]	3 months [n = 4,110]	12 months [n = 4,018]	24 months [n = 4,014]	48 months [n = 4,010]	p-value *
Characteristics	%	%	%	%	%	p-value *
Maternal
Age (years)						0.952
< 19	14.5	14.6	14.5	14.4	14.5
20-24	23.7	23.7	23.6	23.7	23.8
25-30	29.0	29.1	29.1	29.0	28.9
> 30	32.8	32.6	32.8	32.9	32.8
Educational attainment (years)						0.882
0-4	9.2	9.0	8.9	8.9	8.8
5-8	25.6	25.7	25.5	25.8	26.0
9-12	34.1	34.4	34.8	34.5	34.8
> 12	31.1	38.9	30.8	30.8	30.4
Family income (minimum wage)						0.698
≤ 1	12.6	12.6	12.5	12.5	12.4
1.1-3.0	47.1	47.1	47.1	47.3	47.7
3.1-6.0	26.4	26.5	26.6	26.5	26.5
6.1-10.0	7.6	7.5	7.5	7.4	7.4
> 10.0	6.3	6.3	6.3	6.3	6.0
Skin color						0.751
White	70.9	70.8	70.9	70.7	70.3
Black	15.6	15.7	15.8	15.9	16.0
Mixed-race/Yellow/Other	13.5	13.5	13.3	13.4	13.7
Living with a partner						0.991
No	14.2	14.2	13.9	14.0	14.2
Yes	85.8	85.8	86.1	86.0	85.8
Child
Sex						0.977
Male	50.6	50.5	50.9	50.6	50.6
Female	49.4	49.5	49.1	49.4	49.4
Gestational age (weeks)						0.994
Preterm (< 37)	15.5	14.7	14.6	14.7	14.7
Early term (37-38)	37.1	37.2	37.4	37.4	37.2
Full term (39-40)	39.7	40.2	40.1	39.9	40.2
Late & post term (41-42)	7.8	7.9	7.9	8.0	7.8
Type of delivery						0.973
Vaginal	34.8	35.1	35.0	35.1	35.2
Cesarean section	65.2	64.9	65.9	64.9	64.8
Breastfeeding duration (months)						0.013
No breastfeeding	18.6	16.7	15.8	15.3	13.3
≤ 6	33.5	34.2	34.5	34.9	35.7
7-12	16.4	16.9	17.2	17.1	17.5
> 12	31.5	32.2	32.5	32.7	33.5
Maternal perception of child’s health						< 0.001
Excellent	-	-	47.8	40.0	38.0
Very good/Good	-	-	47.4	52.8	55.1
Regular/Bad	-	-	4.8	7.2	6.8

Characteristics	Medications use prevalence [% (95%CI)]
Characteristics	3 months [n = 4.106]	12 months [n = 4.017]	24 months [n = 4.005]	48 months [n = 3.994]
Maternal
Age (years)
< 19	64.3 (60.4; 68.1)	59.5 (55.4; 63.4)	46.3 (42.3; 50.4)	39.4 (35.5; 43.4)
20-24	65.6 (62.6; 68.5)	66.2 (63.1; 69.2)	52.3 (49.1; 55.5)	45.7 (42.6; 48.9)
25-30	66.9 (64.2; 69.6)	70.7 (68.0; 73.2)	54.2 (51.3; 57.0)	48.2 (45.3; 51.1)
> 30	69.9 (67.4; 72.3)	71.4 (68.9; 73.8)	53.8 (51.1; 56.4)	51.0 (48.3; 53.7)
Educational attainment (years)	60.5 (55.4; 65.4)	57.1 (51.9; 62.2)	44.7 (39.6; 49.9)	43.0 (37.9; 42.3)
0-4	61.1 (58.1; 64.0)	61.5 (58.5; 64.4)	48.3 (45.3; 51.4)	43.4 (40.4; 46.4)
5-8	66.4 (63.9; 68.8)	68.8 (66.3; 71.1)	51.5 (48.9; 54.2)	46.9 (44.3; 49.5)
9-12	75.1 (72.7; 77.4)	76.4 (73.9; 78.6)	59.3 (56.5; 62.0)	52.2 (49.4; 55.0)
> 12	60.5 (55.4; 65.4)	57.1 (51.9; 62.2)	44.7 (39.6; 49.9)	43.0 (37.9; 42.3)
Family income (minimum wage)
≤ 1	62.1 (57.8; 66.2)	60.4 (56.1; 64.6)	46.0 (41.7; 50.4)	43.5 (39.2; 48.0)
1.1-3.0	64.8 (62.7; 66.9)	66.4 (64.3; 68.5)	50.2 (48.0; 52.5)	46.3 (44.0; 48.5)
3.1-6.0	69.0 (66.1; 71.6)	70.2 (67.3; 72.8)	55.6 (52.6; 58.6)	47.3 (44.3; 50.3)
6.1-10.0	76.4 (71.4; 80.9)	78.3 (73.2; 82.6)	60.0 (54.3; 65.5)	52.4 (46.6; 58.0)
> 10.0	77.2 (71.7; 81.9)	76.8 (71.2; 81.6)	60.5 (54.3; 66.3)	56.7 (50.3; 62.8)
Skin color
White	69.2 (67.5; 70.8)	70.4 (68.7; 72.0)	53.9 (52.1; 55.8)	48.6 (46.8; 50.5)
Black	60.2 (56.4; 63.9)	62.8 (58.9; 66.5)	48.9 (45.0; 52.8)	44.6 (40.8; 48.5)
Mixed-race/Yellow/Other	64.9 (60.8; 68.8)	63.2 (59.0; 67.2)	48.8 (44.6; 53.0)	43.3 (39.2; 47.5)
Living with a partner
No	31.3 (27.6; 35.2)	61.4 (57.3; 65.4)	50.7 (46.7; 54.8)	45.4 (41.3; 49.5)
Yes	67.0 (65.4; 68.5)	69.3 (67.8; 70.8)	52.8 (51.1; 54.4)	47.6 (45.9; 49.2)
Child
Sex
Male	68.8 (66.7; 70.7)	70.5 (68.5; 72.4)	53.9 (51.7; 56.0)	46.9 (44.8; 49.1)
Female	65.6 (63.5; 67.7)	65.8 (63.7; 67.9)	51.0 (48.8; 53.2)	47.6 (45.4; 49.8)
Gestational age (weeks)
Preterm (< 37)	78.7 (75.2; 81.8)	73.1 (69.4; 76.6)	53.3 (49.3; 57.3)	47.4 (43.4; 51.5)
Early term (37-38)	69.6 (67.2; 71.8)	69.2 (66.8; 71.5)	53.3 (50.8; 55.8)	50.1 (47.6; 52.7)
Full term (39-40)	62.3 (60.0; 64.7)	66.6 (64.3; 69.9)	52.5 (50.0; 54.9)	45.1 (42.7; 47.5)
Late & post term (41-42)	59.4 (54.0; 64.7)	62.3 (56.8; 67.5)	46.7 (41.3; 52.2)	44.2 (38.8; 49.8)
Type of delivery
Vaginal	63.3 (60.8; 65.8)	63.5 (60.9; 66.0)	46.8 (44.2; 49.4)	43.3 (40.7; 45.9)
Cesarean section	69.3 (67.5; 71.0)	70.8 (69.0; 72.5)	55.6 (53.6; 57.4)	49.4 (47.5; 51.3)
Breastfeeding duration (months)
No breastfeeding	67.0 (63.4; 70.4)	65.3 (61.5; 68.9)	51.3 (47.3; 55.2)	44.8 (40.6; 49.1)
≤ 6	71.0 (68.6; 73.3)	69.4 (66.9; 71.8)	54.3 (51.7; 56.9)	47.6 (45.1; 50.2)
7-12	-	69.9 (65.4; 72.3)	53.2 (49.5; 56.9)	50.8 (47.1; 54.5)
> 12	-	68.0 (65.4; 70.4)	50.6 (47.9; 53.3)	45.9 (43.3; 48.6)
Maternal perception of child’s health
Excellent	-	64.1 (62.0; 66.2)	44.8 (42.4; 47.3)	39.4 (37.0; 41.9)
Very good/Good	-	70.6 (68.5; 72.6)	55.5 (53.3; 57.6)	49.5 (47.4; 51.6)
Regular/Bad	-	85.0 (79.1; 89.3)	72.8 (67.3; 77.6)	72.5 (66.9; 77.5)
Total	67.2 (65.8; 68.6)	68.2 (66.8; 69.6)	52.4 (50.9; 54.0)	47.2 (45.7; 48.8)

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[1] Correspondência
S. Farías-Antúnez Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas. Rua Marechal Deodoro 1160, 4° andar, Pelotas, RS 96020-080, Brasil. simonefarias86@yahoo.com.br