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Fetal outcomes after maternal exposure to oral antifungal agents during pregnancy: A systematic review and meta‐analysis
Author(s) -
Liu Dan,
Zhang Chuan,
Wu Lin,
Zhang Li,
Zhang Lingli
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12993
Subject(s) - medicine , fluconazole , pregnancy , itraconazole , cohort study , population , obstetrics , adverse effect , relative risk , meta analysis , antifungal , confidence interval , dermatology , environmental health , genetics , biology
Objective To assess the risk of adverse fetal outcomes after exposure to oral antifungal agents during pregnancy. Search strategy PubMed, Embase, and Cochrane Central Register of Controlled Trials ( CENTRAL ) were searched up to October 2018. Selection criteria Cohort studies and case–control studies investigating fetal outcomes following maternal exposure to oral antifungal agents. Data collection and analysis Two reviewers independently assessed studies for inclusion, assessed risk of bias, and extracted data. Pooled estimates were calculated for the frequency of adverse fetal outcomes. Main results Overall, eight cohort studies and one case–control study were included. The oral antifungal agents used during pregnancy were fluconazole and itraconazole. The data indicated that oral fluconazole exposure during pregnancy might slightly increase the risk of congenital heart defects and limb defects relative to the general population; oral itraconazole during pregnancy might increase the risk of eye defects. No difference was found between oral fluconazole/itraconazole exposure and non‐exposure in the risk of other birth defects, spontaneous abortion, or stillbirth. Conclusion Oral fluconazole or itraconazole may not increase the risk of birth defects. Nonetheless, the risk of congenital heart defects and limb defects after fluconazole exposure and eye defects after itraconazole exposure should be cautiously investigated.