Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis
Abstract Background Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. Methods Studies publ...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-05-01
|
Series: | Orphanet Journal of Rare Diseases |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s13023-018-0789-3 |
id |
doaj-63106735585f498aa6c5e676f97a98a2 |
---|---|
record_format |
Article |
spelling |
doaj-63106735585f498aa6c5e676f97a98a22020-11-25T00:56:21ZengBMCOrphanet Journal of Rare Diseases1750-11722018-05-0113112310.1186/s13023-018-0789-3Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysisNadine Zwink0Ekkehart Jenetzky1Department of Child and Adolescent Psychiatry, University Medical Center of the Johannes Gutenberg UniversityDepartment of Child and Adolescent Psychiatry, University Medical Center of the Johannes Gutenberg UniversityAbstract Background Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. Methods Studies published between 1977 and April 2017 were reviewed through systematic search in PubMed, ISI Web of Knowledge and Scopus databases. Furthermore, related and cross-referencing publications were reviewed. Pooled odds ratios (95% confidence intervals) were determined to quantify associations of maternal periconceptional use of folic acid, multivitamins, anti-asthma medication (separated in any anti-asthma medication, inhaled corticosteroids and salbutamol), thyroid hormone supplements, psychiatric drugs (separated in antidepressants, any selective serotonin reuptake inhibitors [SSRI], sertraline, citalopram, fluoxetine, paroxetine, hypnotics and benzodiazepine) and aspirin with ARM using meta-analyses. Results Thirty-seven studies that reported on the association between maternal periconceptional drug intake and infants born with ARM were included in this review. These were conducted in the United States of America (n = 14), Sweden (n = 6), Hungary (n = 5), Germany (n = 3), the Netherlands (n = 3), Denmark (n = 2), France (n = 2), Norway (n = 1) and the UK (n = 1). However, only few of these studies reported on the same risk factors. Studies were heterogeneous with respect to case numbers, period ingestion of medical drug use, control selection and adjustment for covariates. Consistently increased risks were observed for any anti-asthma medication, and hypnotics and benzodiazepine, but not for folic acid, multivitamins, inhaled corticosteroids, salbutamol, thyroid hormone supplements, antidepressants, any SSRI, sertraline, citalopram, fluoxetine, paroxetine and aspirin. In meta-analyses, pooled odds ratios (95% confidence intervals) for any anti-asthma medication, and hypnotics and benzodiazepine were 1.64 (1.22–2.21), and 2.43 (1.03–5.73), respectively. Conclusion Evidence on maternal drug use before conception and during pregnancy as risk factor for ARM from epidemiological studies is still very limited. Nevertheless, the few available studies indicate any anti-asthma medication, and hypnotics and benzodiazepine to be associated with increased risks. Further, ideally large-scale multicenter and register-based studies are needed to clarify the role of maternal drug intake for the development of ARM.http://link.springer.com/article/10.1186/s13023-018-0789-3Anorectal malformationsImperforate anusAnal atresiaBirth defectsRisk factorsMedication |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nadine Zwink Ekkehart Jenetzky |
spellingShingle |
Nadine Zwink Ekkehart Jenetzky Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis Orphanet Journal of Rare Diseases Anorectal malformations Imperforate anus Anal atresia Birth defects Risk factors Medication |
author_facet |
Nadine Zwink Ekkehart Jenetzky |
author_sort |
Nadine Zwink |
title |
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
title_short |
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
title_full |
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
title_fullStr |
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
title_full_unstemmed |
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
title_sort |
maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis |
publisher |
BMC |
series |
Orphanet Journal of Rare Diseases |
issn |
1750-1172 |
publishDate |
2018-05-01 |
description |
Abstract Background Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. Methods Studies published between 1977 and April 2017 were reviewed through systematic search in PubMed, ISI Web of Knowledge and Scopus databases. Furthermore, related and cross-referencing publications were reviewed. Pooled odds ratios (95% confidence intervals) were determined to quantify associations of maternal periconceptional use of folic acid, multivitamins, anti-asthma medication (separated in any anti-asthma medication, inhaled corticosteroids and salbutamol), thyroid hormone supplements, psychiatric drugs (separated in antidepressants, any selective serotonin reuptake inhibitors [SSRI], sertraline, citalopram, fluoxetine, paroxetine, hypnotics and benzodiazepine) and aspirin with ARM using meta-analyses. Results Thirty-seven studies that reported on the association between maternal periconceptional drug intake and infants born with ARM were included in this review. These were conducted in the United States of America (n = 14), Sweden (n = 6), Hungary (n = 5), Germany (n = 3), the Netherlands (n = 3), Denmark (n = 2), France (n = 2), Norway (n = 1) and the UK (n = 1). However, only few of these studies reported on the same risk factors. Studies were heterogeneous with respect to case numbers, period ingestion of medical drug use, control selection and adjustment for covariates. Consistently increased risks were observed for any anti-asthma medication, and hypnotics and benzodiazepine, but not for folic acid, multivitamins, inhaled corticosteroids, salbutamol, thyroid hormone supplements, antidepressants, any SSRI, sertraline, citalopram, fluoxetine, paroxetine and aspirin. In meta-analyses, pooled odds ratios (95% confidence intervals) for any anti-asthma medication, and hypnotics and benzodiazepine were 1.64 (1.22–2.21), and 2.43 (1.03–5.73), respectively. Conclusion Evidence on maternal drug use before conception and during pregnancy as risk factor for ARM from epidemiological studies is still very limited. Nevertheless, the few available studies indicate any anti-asthma medication, and hypnotics and benzodiazepine to be associated with increased risks. Further, ideally large-scale multicenter and register-based studies are needed to clarify the role of maternal drug intake for the development of ARM. |
topic |
Anorectal malformations Imperforate anus Anal atresia Birth defects Risk factors Medication |
url |
http://link.springer.com/article/10.1186/s13023-018-0789-3 |
work_keys_str_mv |
AT nadinezwink maternaldruguseandtheriskofanorectalmalformationssystematicreviewandmetaanalysis AT ekkehartjenetzky maternaldruguseandtheriskofanorectalmalformationssystematicreviewandmetaanalysis |
_version_ |
1725227669944008704 |