Pregnancy outcomes following maternal macrolide use: A systematic review and meta-analysis

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dc.authorscopusid57115537300
dc.authorscopusid57214465311
dc.authorscopusid57214440508
dc.authorscopusid6602326304
dc.authorscopusid26643347900
dc.authorscopusid56541140000
dc.contributor.authorKeskin-Arslan, E.
dc.contributor.authorErol, H.
dc.contributor.authorUysal, N.
dc.contributor.authorKaradas, B.
dc.contributor.authorTemiz, T.
dc.contributor.authorKaplan, Y.C.
dc.date.accessioned2024-08-25T18:36:36Z
dc.date.available2024-08-25T18:36:36Z
dc.date.issued2023
dc.departmentEge Üniversitesien_US
dc.description.abstractTo 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.en_US
dc.description.sponsorshipTürkiye Bilimsel ve Teknolojik Araştırma Kurumu, TÜBİTAKen_US
dc.description.sponsorshipWe thank to Per Damkier and Anne Broe for sharing their unpublished data with us. Preliminary results of this study were presented as an oral presentation at 30th ENTIS Conference 5–7 September 2019, Oslo-Norway by Elif Keskin-Arslan. The congress participation of this author was supported by the Scientific and Technological Research Council of Turkey ( TUBITAK ) 2224-International Scientific Meetings Fellowship Programme 2019/4.en_US
dc.identifier.doi10.1016/j.reprotox.2022.12.003
dc.identifier.endpage146en_US
dc.identifier.issn0890-6238
dc.identifier.pmid36549458en_US
dc.identifier.scopus2-s2.0-85145693098en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage124en_US
dc.identifier.urihttps://doi.org/10.1016/j.reprotox.2022.12.003
dc.identifier.urihttps://hdl.handle.net/11454/100694
dc.identifier.volume115en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofReproductive Toxicologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240825_Gen_US
dc.subjectAzithromycinen_US
dc.subjectClarithromycinen_US
dc.subjectErythromycinen_US
dc.subjectMacrolidesen_US
dc.subjectMeta-analysisen_US
dc.subjectPregnancy outcomesen_US
dc.subjectRoxithromycinen_US
dc.subjectazithromycinen_US
dc.subjectclarithromycinen_US
dc.subjecterythromycinen_US
dc.subjectmacrolideen_US
dc.subjectroxithromycinen_US
dc.subjectantiinfective agenten_US
dc.subjectazithromycinen_US
dc.subjecterythromycinen_US
dc.subjectmacrolideen_US
dc.subjectalcohol consumptionen_US
dc.subjectArticleen_US
dc.subjectcongenital heart malformationen_US
dc.subjectcongenital malformationen_US
dc.subjectdata extractionen_US
dc.subjectfirst trimester pregnancyen_US
dc.subjectheart ventricle septum defecten_US
dc.subjectHelicobacter pylorien_US
dc.subjecthumanen_US
dc.subjectlive birthen_US
dc.subjectmeta analysisen_US
dc.subjectnervous systemen_US
dc.subjectpregnancyen_US
dc.subjectpregnancy outcomeen_US
dc.subjectquality controlen_US
dc.subjectsensitivity analysisen_US
dc.subjectsmokingen_US
dc.subjectspontaneous abortionen_US
dc.subjectsystematic reviewen_US
dc.subjectultrasounden_US
dc.subjecturogenital systemen_US
dc.subjectepidemiologyen_US
dc.subjectfemaleen_US
dc.subjectpregnancy outcomeen_US
dc.subjectAnti-Bacterial Agentsen_US
dc.subjectAzithromycinen_US
dc.subjectErythromycinen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectMacrolidesen_US
dc.subjectPregnancyen_US
dc.subjectPregnancy Outcomeen_US
dc.titlePregnancy outcomes following maternal macrolide use: A systematic review and meta-analysisen_US
dc.typeArticleen_US

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