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Published on: March 6, 2018
Does the use of bisphosphonates during pregnancy affect fetal outcomes? A systematic review
Wladimir Gushiken de Campos1, Rita Araújo2,3, Vinícius Teixeira4
1Department of Oral Medicine, School of Dentistry, University of São Paulo, São Paulo, Brazil. wgushiken@hotmail.com.
Insights
Maternal exposure to bisphosphonates (BPs) during pregnancy may be linked to adverse neonatal outcomes. However, these associations require cautious interpretation and further research for definitive clinical guidance.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Pharmacology
Background:
- Bisphosphonates (BPs) are commonly used to treat bone diseases.
- Maternal BPs exposure during pregnancy raises concerns regarding potential neonatal effects.
- Limited data exists on the comprehensive impact of BPs on neonatal outcomes.
Approach:
- A systematic review was conducted by searching major scientific databases (PubMed, Science Direct, LILACS, EMBASE, Web of Science) until August 2022.
- Studies involving pregnant women exposed to BPs were selected based on predefined criteria.
- 13 studies encompassing 106 women (108 pregnancies) met the inclusion criteria.
Key Points:
- Neonatal outcomes reported included spontaneous abortion, congenital malformations, hypocalcemia, preterm birth, and low birth weight.
- BP exposure occurred at various gestational stages for different therapeutic indications.
- Risk of bias assessment was performed on the included studies.
Conclusions:
- Existing evidence suggests potential adverse neonatal outcomes associated with maternal bisphosphonate use before or during pregnancy.
- The findings necessitate cautious interpretation due to the complexity and limitations of current data.
- Further research is crucial to establish definitive insights and guide clinical decision-making regarding BPs in pregnancy.
Purpose:
This systematic review aimed to determine the effects of maternal exposure to bisphosphonates (BPs) during pregnancy on neonatal outcomes. It aimed to disclosfe the impact of BPs on neonates and identify aspects that require further investigation.
Methods:
A comprehensive search of PubMed, Science Direct, LILACS, EMBASE, and Web of Science was conducted until August 2022, with no time restrictions. The selection criteria included studies published in English that evaluated pregnant women who were exposed to BPs.
Results:
From an initial pool of 2169 studies, 13 met the inclusion criteria for this systematic review. These studies collectively included 106 women (108 pregnancies) who were exposed to BPs either before orduring pregnancy. A summary of the key characteristics of the selected studies and the risk of bias assessment are provided. Exposure to BPs occurs at various stages of pregnancy, with different indications for BP treatment. The most frequently reported neonatal outcomes were spontaneous abortion, congenital malformations, hypocalcemia, preterm birth, and low birth weight.
Conclusion:
Although previous reports have linked BPs before or during pregnancy with adverse neonatal outcomes, these associations should be interpreted with caution. Given the complexity of these findings, further research is necessary to provide more definitive insights to guide clinical decisions regarding the use of BPs in pregnant women.
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