Maternal spermicide use and adverse reproductive outcome: a meta-analysis

A meta-analysis was performed to determine whether the literature provides evidence that periconceptual or postconceptual maternal use of spermicides is detrimental to the developing fetus. Nine studies that investigated teratogenicity met the inclusion criteria. The Mantel-Haenszel summary odds ratio was 1.02 (95% confidence interval = 0.78 to 1.32). The chi 2 analyses was 0.10 for significance from unity (p = 0.748) and 8.73 for homogeneity of effects (p = 0.365). Studies comparing specific abnormalities with other abnormalities also indicated no association (odds ratio = 0.96; 95% confidence interval = 0.72 to 1.28). Studies investigating other adverse events (spontaneous abortion, stillbirth, reduced fetal weight, prematurity, or increased incidence of female births) showed similar negative results. Cohen's d, the overall effect size as determined by Tukey's jackknife method, was -0.001 (95% confidence interval = -0.018 to 0.017). These results indicate that maternal use of spermicides is not associated with adverse fetal outcomes. Meta-analysis adds quantitative support for conclusions from traditional reviews of the subject.