Does the use of bisphosphonates during pregnancy affect fetal outcomes? A systematic review

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2024-05-01 DOI:10.1007/s00228-024-03693-7

Wladimir Gushiken de Campos, Rita Araújo, Vinícius Teixeira, Pedro Sousa Gomes, Celso Augusto Lemos

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引用次数: 0

Abstract

Purpose

This systematic review aimed to determine the effects of maternal exposure to bisphosphonates (BPs) during pregnancy on neonatal outcomes. It aimed to disclosfe the impact of BPs on neonates and identify aspects that require further investigation.

Methods

A comprehensive search of PubMed, Science Direct, LILACS, EMBASE, and Web of Science was conducted until August 2022, with no time restrictions. The selection criteria included studies published in English that evaluated pregnant women who were exposed to BPs.

Results

From an initial pool of 2169 studies, 13 met the inclusion criteria for this systematic review. These studies collectively included 106 women (108 pregnancies) who were exposed to BPs either before orduring pregnancy. A summary of the key characteristics of the selected studies and the risk of bias assessment are provided. Exposure to BPs occurs at various stages of pregnancy, with different indications for BP treatment. The most frequently reported neonatal outcomes were spontaneous abortion, congenital malformations, hypocalcemia, preterm birth, and low birth weight.

Conclusion

Although previous reports have linked BPs before or during pregnancy with adverse neonatal outcomes, these associations should be interpreted with caution. Given the complexity of these findings, further research is necessary to provide more definitive insights to guide clinical decisions regarding the use of BPs in pregnant women.

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孕期使用双膦酸盐会影响胎儿结局吗？系统回顾

目的本系统综述旨在确定妊娠期母体接触双膦酸盐（BPs）对新生儿预后的影响。方法截至 2022 年 8 月，对 PubMed、Science Direct、LILACS、EMBASE 和 Web of Science 进行了全面检索，没有时间限制。选择标准包括以英文发表的、对暴露于碱性磷酸酶的孕妇进行评估的研究。结果在最初的 2169 项研究中，有 13 项符合本系统综述的纳入标准。这些研究共纳入了 106 名妇女（108 例妊娠），她们在妊娠前和妊娠期间均接触过 BPs。本文概述了所选研究的主要特点和偏倚风险评估。暴露于 BPs 的情况发生在妊娠的不同阶段，BP 治疗的适应症也各不相同。最常报道的新生儿结局是自然流产、先天性畸形、低钙血症、早产和出生体重不足。鉴于这些研究结果的复杂性，有必要开展进一步的研究，以提供更明确的见解，指导临床决定是否在孕妇中使用降压药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.