Use of dipyrone during pregnancy and risk of congenital anomalies: a systematic review.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-01-01 Epub Date: 2024-10-24 DOI:10.1007/s00228-024-03769-4

Karine Duarte Curvello, Helana Ortiz Garcia, Tatiana da Silva Sempé, Raimunda Alyne Maciel Feitosa da Silva, Luana Giongo Pedrotti, Fernanda Sales Luiz Vianna, Tatiane da Silva Dal Pizzol

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引用次数: 0

Abstract

Purpose: This study aimed to summarize the evidence on the teratogenic effects of dipyrone used during pregnancy.

Methods: Databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science, Lilacs, SciELO, SCOPUS, OasisBR, and OpenGray) were reviewed until September 2023. We included studies that compared pregnant women who used dipyrone during any gestational period with those who used other analgesics or did not use any analgesics during the same gestational period. The outcome assessed was the presence of any congenital anomaly. Two reviewers independently conducted the review process, and a third reviewer resolved any disagreements. The risk of bias was assessed using the Joanna Briggs Institute tool for observational studies. The reviewed data synthesis is presented in narrative form.

Results: The search retrieved 2045 results, of which seven studies were included in the review, four were case‒control studies, and three were cohort studies involving 153,562 participants. The congenital anomalies evaluated varied across studies, with unspecified congenital anomalies predominating. Five of seven studies found no association between dipyrone and congenital anomalies. In a case‒control study, a positive association was found between dipyrone use and isolated congenital cataracts compared to two control groups; in another study, a positive association for unspecified congenital anomalies was observed in only one of the two control groups analyzed. In all studies, a high risk of bias was identified, especially regarding measuring the exposure, outcome, and assessment of confounding factors.

Conclusion: There is not enough evidence to define the risk of congenital anomalies associated with dipyrone use during pregnancy.

Registration: CRD 42022333041.

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孕期使用地匹隆与先天性畸形的风险：系统综述。

目的：本研究旨在总结有关妊娠期使用地匹隆致畸作用的证据：我们查阅了截至 2023 年 9 月的数据库（MEDLINE、EMBASE、Cochrane Library、CINAHL、Web of Science、Lilacs、SciELO、SCOPUS、OasisBR 和 OpenGray）。我们纳入的研究对在任何妊娠期使用地匹隆的孕妇与在同一妊娠期使用其他镇痛药或未使用任何镇痛药的孕妇进行了比较。评估结果为是否存在任何先天性畸形。两名审稿人独立完成审稿工作，第三名审稿人负责解决任何分歧。采用乔安娜-布里格斯研究所的观察性研究工具对偏倚风险进行评估。综述数据以叙述形式呈现：搜索共检索到 2045 项结果，其中 7 项研究被纳入综述，4 项为病例对照研究，3 项为队列研究，涉及 153562 名参与者。不同研究评估的先天性畸形各不相同，其中以不明先天性畸形为主。七项研究中有五项发现，二吡喃酮与先天性畸形之间没有关联。在一项病例对照研究中，与两个对照组相比，发现使用吡咯酮与孤立性先天性白内障之间存在正相关；在另一项研究中，仅在分析的两个对照组中的一个中观察到与未指定的先天性畸形存在正相关。在所有研究中，偏倚风险都很高，尤其是在测量暴露、结果和评估混杂因素方面：结论：目前还没有足够的证据来确定妊娠期使用地匹隆导致先天性畸形的风险：注册号：CRD 42022333041。

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.