Pregnancy outcomes following maternal macrolide use: A systematic review and meta-analysis
Küçük Resim Yok
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Inc.
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
To determine whether gestational use of all or specific macrolides (azithromycin, clarithromycin, roxithromycin or erythromycin) lead to an increase in rates of overall major congenital malformations, organ-specific malformations, and other adverse pregnancy outcomes in infants. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and Reprotox® databases were searched. Dichotomous outcomes or calculated log odds ratios and standard errors from observational studies are combined using the random-effects method in Review Manager 5.3. No significant increased risks for major congenital malformation (OR 1.06 [95% CI 0.99, 1.13]) and congenital heart defect (OR 1.05 [95% CI 0.92, 1.19]) following all macrolides use during the first trimester were detected. Prenatal azithromycin use was associated with a significantly increased risk of major congenital malformations in the analysis of cohort studies (OR 1.21 [95% CI 1.08–1.36]). This significance was also present in the sensitivity analysis. There were no statistically significant associations between the risk of organ specific malformations and all or specific macrolide exposures except for the decreased risk in hypospadias following erythromycin use in the meta-analysis of case-control studies (OR 0.38 [95% CI 0.18, 0.81]. Also, a significant 1.5-fold increased risk for spontaneous abortion following macrolide use was detected. A slight yet significantly increased rate of major congenital malformation with azithromycin exposure during pregnancy may be associated with maternal confounders. Nevertheless, level II ultrasound can be suggested following maternal azithromycin use during the first trimester. Future studies should take into account the inclusion of a disease-matched control group and accurate classification of the malformations. © 2022 Elsevier Inc.
Açıklama
Anahtar Kelimeler
Azithromycin, Clarithromycin, Erythromycin, Macrolides, Meta-analysis, Pregnancy outcomes, Roxithromycin, azithromycin, clarithromycin, erythromycin, macrolide, roxithromycin, antiinfective agent, azithromycin, erythromycin, macrolide, alcohol consumption, Article, congenital heart malformation, congenital malformation, data extraction, first trimester pregnancy, heart ventricle septum defect, Helicobacter pylori, human, live birth, meta analysis, nervous system, pregnancy, pregnancy outcome, quality control, sensitivity analysis, smoking, spontaneous abortion, systematic review, ultrasound, urogenital system, epidemiology, female, pregnancy outcome, Anti-Bacterial Agents, Azithromycin, Erythromycin, Female, Humans, Macrolides, Pregnancy, Pregnancy Outcome
Kaynak
Reproductive Toxicology
WoS Q Değeri
Scopus Q Değeri
Q2
Cilt
115
