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Published on: August 9, 2014
Prenatal NSAIDs exposure and childhood kidney disease: a systematic review and meta-analysis
Xinping Cui1, Rong Feng1, Bin Song2
1North Sichuan Medical College, Nanchong, China.
Objective:
Studies have shown a link between prenatal NSAIDs exposure and childhood kidney disease; however, consensus is lacking. Therefore, we conducted a meta-analysis to assess maternal prenatal exposure to NSAIDs and its relationship with the kidney disease risk in children.
Methods:
A systematic search of PubMed, Cochrane Library, Embase, and Web of Science was performed, supplemented by a manual search of references, to identify relevant observational studies for our analysis. Data extraction and quality assessment were independently conducted by two investigators. A random effects meta-analysis was conducted to estimate the summary odds ratio (ORs) and the corresponding 95% confidence interval (CIs).
Results:
Seven studies including 4,159,617 participants were selected. The analysis indicated that there was an association between prenatal NSAIDs exposure and kidney disease risk in children (OR 1.36 [1.14-1.62]). After adjusted (OR 2.40 [1.84-3.13]) and unadjusted (OR 1.10 [1.05-1.15]) analyses, the use of NSAIDs during pregnancy was associated with the kidney disease risk in children. Use of NSAIDs in the second and third trimesters of pregnancy is associated with the kidney disease risk in children (second-trimester OR 1.17 [1.09-1.26] and third-trimester OR 1.10 [1.09-1.11]). Sensitivity analysis supported these findings.
Conclusion:
With our meta-analysis, we provide evidence for an association between prenatal NSAIDs exposure and kidney diseases in children but do not solve the causality issues concerning potential confounding by other risk factors. More high-quality studies are needed to establish whether the association with NSAIDs is causal.
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