Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis
Purpose This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation. Methods We conducted a systematic search of multiple databases, including PubMed, Web of Science, Em...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2024-09, Vol.310 (3), p.1331-1342 |
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| creator | Jingran, Gao Yan, Du Xiaoying, Yao |
| description | Purpose
This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation.
Methods
We conducted a systematic search of multiple databases, including PubMed, Web of Science, Embase, Cochrane, CNKI, and CBM, from their inception to February 2024, with no language restrictions. We included cohort and case–control studies that analyzed the teratogenic effects of mifepristone and/or misoprostol on fetuses and newborns. Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The odds ratios (OR) from individual studies were combined using meta-analysis. Sensitivity testing and heterogeneity analysis were conducted.
Results
A total of 13 studies were eligible for inclusion, comprising 5193 cases of congenital malformations and 12,232 controls.
Conclusion
Our findings indicated that the use of misoprostol during early pregnancy increased the risk of congenital abnormalities in offspring (OR = 2.69; 95% CI: 1.57–4.62). However, the potential teratogenic effect of mifepristone during pregnancy cannot be ruled out. Additionally, the use of mifepristone and/or misoprostol has been linked to a higher risk of certain congenital anomalies, such as hydrocephalus (OR = 3.41; 95% CI: 1.17–9.97), Möbius syndrome (OR = 26.48; 95% CI: 11.30–62.01), and terminal transverse limb defects (OR = 10.75; 95% CI: 3.93–29.41). (PROSPERO, CRD42024522093, 03182024). |
| doi_str_mv | 10.1007/s00404-024-07616-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3077188412</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3099338653</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-b90da92e3c6fd51efff071f6b93022f93fb69299659ebf6b05b76fa1b4626faf3</originalsourceid><addsrcrecordid>eNp9kctu1TAQhq0KRG-8AAtkiQ2bUF8SJ2aHKmiRKiEhuracZHzkktgH2-E0r8ETM4fTAmLBwhp7_M3vGf-EvODsDWesvciM1ayumMDVKq6q3RE54bUUeOT8yV_7Y3Ka8x1jXHSdekaOZac7Juv2hPz47PNXGh0tkGyJGwh-8GWlPtAhhuLDAiPdJtgEG4aVWocc3UAutvgY7EThfhvzkoCWSGfvYJt8LjEAtWG8iAlzOW5TxNz0llqa11xgxuKBJvjuYbfn6AzFVhbl1uzzOXnq7JTh-UM8I7cf3n-5vK5uPl19vHx3Uw2iUaXqNRutFiAH5caGg3MOR3Wq15IJ4bR0vdJCa9Vo6DHNmr5VzvK-VgKjk2fk9UEX2_u24EgGex1gmmyAuGQjWdvyrqu5QPTVP-hdXBL2u6e0lrJTjURKHKgB580JnMHPmG1aDWdm75g5OGbQMfPLMbPDopcP0ks_w_i75NEiBOQByHgVNpD-vP0f2Z97faW8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3099338653</pqid></control><display><type>article</type><title>Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Jingran, Gao ; Yan, Du ; Xiaoying, Yao</creator><creatorcontrib>Jingran, Gao ; Yan, Du ; Xiaoying, Yao</creatorcontrib><description>Purpose
This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation.
Methods
We conducted a systematic search of multiple databases, including PubMed, Web of Science, Embase, Cochrane, CNKI, and CBM, from their inception to February 2024, with no language restrictions. We included cohort and case–control studies that analyzed the teratogenic effects of mifepristone and/or misoprostol on fetuses and newborns. Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The odds ratios (OR) from individual studies were combined using meta-analysis. Sensitivity testing and heterogeneity analysis were conducted.
Results
A total of 13 studies were eligible for inclusion, comprising 5193 cases of congenital malformations and 12,232 controls.
Conclusion
Our findings indicated that the use of misoprostol during early pregnancy increased the risk of congenital abnormalities in offspring (OR = 2.69; 95% CI: 1.57–4.62). However, the potential teratogenic effect of mifepristone during pregnancy cannot be ruled out. Additionally, the use of mifepristone and/or misoprostol has been linked to a higher risk of certain congenital anomalies, such as hydrocephalus (OR = 3.41; 95% CI: 1.17–9.97), Möbius syndrome (OR = 26.48; 95% CI: 11.30–62.01), and terminal transverse limb defects (OR = 10.75; 95% CI: 3.93–29.41). (PROSPERO, CRD42024522093, 03182024).</description><identifier>ISSN: 1432-0711</identifier><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-024-07616-w</identifier><identifier>PMID: 38980347</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abnormalities, Drug-Induced - epidemiology ; Abnormalities, Drug-Induced - etiology ; Abortifacient Agents, Nonsteroidal - adverse effects ; Abortifacient Agents, Steroidal - administration & dosage ; Abortifacient Agents, Steroidal - adverse effects ; Endocrinology ; Female ; Gynecology ; Human Genetics ; Humans ; Infant, Newborn ; Medicine ; Medicine & Public Health ; Mifepristone - administration & dosage ; Mifepristone - adverse effects ; Misoprostol - administration & dosage ; Misoprostol - adverse effects ; Obstetrics/Perinatology/Midwifery ; Pregnancy ; Review</subject><ispartof>Archives of gynecology and obstetrics, 2024-09, Vol.310 (3), p.1331-1342</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-b90da92e3c6fd51efff071f6b93022f93fb69299659ebf6b05b76fa1b4626faf3</cites><orcidid>0000-0003-2040-5104</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-024-07616-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-024-07616-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38980347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jingran, Gao</creatorcontrib><creatorcontrib>Yan, Du</creatorcontrib><creatorcontrib>Xiaoying, Yao</creatorcontrib><title>Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation.
Methods
We conducted a systematic search of multiple databases, including PubMed, Web of Science, Embase, Cochrane, CNKI, and CBM, from their inception to February 2024, with no language restrictions. We included cohort and case–control studies that analyzed the teratogenic effects of mifepristone and/or misoprostol on fetuses and newborns. Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The odds ratios (OR) from individual studies were combined using meta-analysis. Sensitivity testing and heterogeneity analysis were conducted.
Results
A total of 13 studies were eligible for inclusion, comprising 5193 cases of congenital malformations and 12,232 controls.
Conclusion
Our findings indicated that the use of misoprostol during early pregnancy increased the risk of congenital abnormalities in offspring (OR = 2.69; 95% CI: 1.57–4.62). However, the potential teratogenic effect of mifepristone during pregnancy cannot be ruled out. Additionally, the use of mifepristone and/or misoprostol has been linked to a higher risk of certain congenital anomalies, such as hydrocephalus (OR = 3.41; 95% CI: 1.17–9.97), Möbius syndrome (OR = 26.48; 95% CI: 11.30–62.01), and terminal transverse limb defects (OR = 10.75; 95% CI: 3.93–29.41). (PROSPERO, CRD42024522093, 03182024).</description><subject>Abnormalities, Drug-Induced - epidemiology</subject><subject>Abnormalities, Drug-Induced - etiology</subject><subject>Abortifacient Agents, Nonsteroidal - adverse effects</subject><subject>Abortifacient Agents, Steroidal - administration & dosage</subject><subject>Abortifacient Agents, Steroidal - adverse effects</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Gynecology</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mifepristone - administration & dosage</subject><subject>Mifepristone - adverse effects</subject><subject>Misoprostol - administration & dosage</subject><subject>Misoprostol - adverse effects</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Pregnancy</subject><subject>Review</subject><issn>1432-0711</issn><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctu1TAQhq0KRG-8AAtkiQ2bUF8SJ2aHKmiRKiEhuracZHzkktgH2-E0r8ETM4fTAmLBwhp7_M3vGf-EvODsDWesvciM1ayumMDVKq6q3RE54bUUeOT8yV_7Y3Ka8x1jXHSdekaOZac7Juv2hPz47PNXGh0tkGyJGwh-8GWlPtAhhuLDAiPdJtgEG4aVWocc3UAutvgY7EThfhvzkoCWSGfvYJt8LjEAtWG8iAlzOW5TxNz0llqa11xgxuKBJvjuYbfn6AzFVhbl1uzzOXnq7JTh-UM8I7cf3n-5vK5uPl19vHx3Uw2iUaXqNRutFiAH5caGg3MOR3Wq15IJ4bR0vdJCa9Vo6DHNmr5VzvK-VgKjk2fk9UEX2_u24EgGex1gmmyAuGQjWdvyrqu5QPTVP-hdXBL2u6e0lrJTjURKHKgB580JnMHPmG1aDWdm75g5OGbQMfPLMbPDopcP0ks_w_i75NEiBOQByHgVNpD-vP0f2Z97faW8</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Jingran, Gao</creator><creator>Yan, Du</creator><creator>Xiaoying, Yao</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2040-5104</orcidid></search><sort><creationdate>20240901</creationdate><title>Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis</title><author>Jingran, Gao ; Yan, Du ; Xiaoying, Yao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-b90da92e3c6fd51efff071f6b93022f93fb69299659ebf6b05b76fa1b4626faf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abnormalities, Drug-Induced - epidemiology</topic><topic>Abnormalities, Drug-Induced - etiology</topic><topic>Abortifacient Agents, Nonsteroidal - adverse effects</topic><topic>Abortifacient Agents, Steroidal - administration & dosage</topic><topic>Abortifacient Agents, Steroidal - adverse effects</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Gynecology</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mifepristone - administration & dosage</topic><topic>Mifepristone - adverse effects</topic><topic>Misoprostol - administration & dosage</topic><topic>Misoprostol - adverse effects</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Pregnancy</topic><topic>Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jingran, Gao</creatorcontrib><creatorcontrib>Yan, Du</creatorcontrib><creatorcontrib>Xiaoying, Yao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jingran, Gao</au><au>Yan, Du</au><au>Xiaoying, Yao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>310</volume><issue>3</issue><spage>1331</spage><epage>1342</epage><pages>1331-1342</pages><issn>1432-0711</issn><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation.
Methods
We conducted a systematic search of multiple databases, including PubMed, Web of Science, Embase, Cochrane, CNKI, and CBM, from their inception to February 2024, with no language restrictions. We included cohort and case–control studies that analyzed the teratogenic effects of mifepristone and/or misoprostol on fetuses and newborns. Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The odds ratios (OR) from individual studies were combined using meta-analysis. Sensitivity testing and heterogeneity analysis were conducted.
Results
A total of 13 studies were eligible for inclusion, comprising 5193 cases of congenital malformations and 12,232 controls.
Conclusion
Our findings indicated that the use of misoprostol during early pregnancy increased the risk of congenital abnormalities in offspring (OR = 2.69; 95% CI: 1.57–4.62). However, the potential teratogenic effect of mifepristone during pregnancy cannot be ruled out. Additionally, the use of mifepristone and/or misoprostol has been linked to a higher risk of certain congenital anomalies, such as hydrocephalus (OR = 3.41; 95% CI: 1.17–9.97), Möbius syndrome (OR = 26.48; 95% CI: 11.30–62.01), and terminal transverse limb defects (OR = 10.75; 95% CI: 3.93–29.41). (PROSPERO, CRD42024522093, 03182024).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38980347</pmid><doi>10.1007/s00404-024-07616-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2040-5104</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abnormalities, Drug-Induced - epidemiology Abnormalities, Drug-Induced - etiology Abortifacient Agents, Nonsteroidal - adverse effects Abortifacient Agents, Steroidal - administration & dosage Abortifacient Agents, Steroidal - adverse effects Endocrinology Female Gynecology Human Genetics Humans Infant, Newborn Medicine Medicine & Public Health Mifepristone - administration & dosage Mifepristone - adverse effects Misoprostol - administration & dosage Misoprostol - adverse effects Obstetrics/Perinatology/Midwifery Pregnancy Review |
| title | Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis |
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