Exposure to nitrofurantoin during early pregnancy and congenital malformations: a systematic review and meta-analysis

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC
Ori GoldbergG Koren

Abstract

Because of an increased resistance of urinary pathogens to penicillin derivatives, nitrofurantoin is commonly used as an alternative in treating urinary tract infection because a wide range of both Gram negative and positive organisms are sensitive to it. The safety of the fetus after exposure to nitrofurantoin remains controversial. We conducted a systematic review and meta-analysis to evaluate the fetal safety of nitrofurantoin. We searched Medline, EMBASE, references from published reports, and meeting abstracts for relevant studies. Articles were included in the review if they were human studies, reported pregnancy outcomes, reported the use of nitrofurantoin in the first trimester of pregnancy, and included a comparator group of unexposed pregnancies. The primary outcome was the rate of major malformations; secondary outcomes were rates of craniosynostosis, cleft lip or palate defects, cardiovascular defects, and hypoplastic left heart syndrome. Eight studies reporting on 91 115 exposed cases and 1 578 745 unexposed controls were included in the primary meta-analysis examining the risk of major malformation. Five cohort studies reported on 9275 exposed and 1 491 933 unexposed infants, resulting in an overall RR of 1.01 (95...Continue Reading

Citations

Nov 26, 2015·Pharmacotherapy·P Brandon BookstaverMilena McLaughlin
Dec 18, 2018·The Annals of Pharmacotherapy·Hana RacP Brandon Bookstaver
Jul 20, 2017·British Journal of Clinical Pharmacology·Flory T MuandaAnick Bérard
Jul 5, 2016·Journal of Biochemical and Molecular Toxicology·Mahmoud OmidiAfshin Mohammadi-Bardbori
May 16, 2021·The Journal of International Medical Research·Ala'a MatalkaKhaled Al Oweidat
Jul 2, 2019·American Journal of Obstetrics and Gynecology·Per DamkierAnne Broe

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