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Article ; Online: Neonatal outcomes after neuraminidase inhibitor use during pregnancy: A meta-analysis of cohort studies.

Lian, Jiangshan / Adilijiang, Munire / Chang, Caihua / Jiang, Haiyin / Zhang, Yongping

British journal of clinical pharmacology

2021  Volume 88, Issue 3, Page(s) 911–918

Abstract: Aim: Influenza infection poses a severe threat to pregnant mothers, and antiviral treatment is recommended. However, the safety of neuraminidase-inhibitor antiviral medications during pregnancy has not been well described.: Methods: A systematic ... ...

Abstract Aim: Influenza infection poses a severe threat to pregnant mothers, and antiviral treatment is recommended. However, the safety of neuraminidase-inhibitor antiviral medications during pregnancy has not been well described.
Methods: A systematic review and meta-analysis were performed to evaluate the adverse neonatal outcomes associated with exposure to neuraminidase inhibitors during pregnancy. The PubMed, Embase and Cochrane Library databases were searched to identify potential studies for inclusion.
Results: Nine cohort studies that estimated adverse neonatal outcomes associated with exposure to neuraminidase-inhibitor medication during pregnancy were included. Exposure to a neuraminidase inhibitor during pregnancy was not associated with an increased risk of congenital malformation (odds ratio [OR] 0.9, 95% confidence interval [CI] 0.72-1.12, P = .341), low Apgar score (OR 0.96, 95% CI 0.77-1.2, P = .733) or preterm birth (OR 0.99, 95% CI 0.89-1.09, P = .771) compared with no exposure. However, exposure to a neuraminidase inhibitor was associated with a reduced risk of low birth weight (OR 0.79, 95% CI 0.68-0.92, P = .002) and giving birth to a small-for-gestational-age infant (OR 0.78, 95% CI 0.69-0.88, P < .001). Further analyses limited to oseltamivir exposure were consistent with the overall results.
Conclusion: Exposure to neuraminidase-inhibitor medication during pregnancy does not appear to be associated with adverse neonatal outcomes. We recommend further studies to investigate this association, which will help clinicians determine whether to prescribe a neuraminidase inhibitor during pregnancy.
MeSH term(s) Antiviral Agents/adverse effects ; Cohort Studies ; Enzyme Inhibitors/adverse effects ; Female ; Humans ; Infant ; Infant, Newborn ; Neuraminidase ; Pregnancy ; Pregnancy Outcome/epidemiology ; Premature Birth/chemically induced
Chemical Substances Antiviral Agents ; Enzyme Inhibitors ; Neuraminidase (EC 3.2.1.18)
Language English
Publishing date 2021-09-02
Publishing country England
Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID 188974-6
ISSN 1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online) 1365-2125
ISSN 0306-5251 ; 0264-3774
DOI 10.1111/bcp.15033
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