BACKGROUND: Nonsteroidal antiinflammatory drugs (NSAIDs) are increasingly being used during pregnancy to treat a variety of conditions. An evaluation of the risk of premature closure of the ductus arteriosus is useful in determining the safety of NSAIDs at different stages of pregnancy. OBJECTIVE: To determine whether NSAID use during the third trimester of pregnancy is associated with an increased risk of premature constriction of the ductus arteriosus. METHODS: A systematic review was conducted of MEDLINE (1966-2004), Embase (1980-2004), and the Cochrane Database of Systematic Reviews (1991-2004). Summary estimates of the odds ratios, comparing ductal outcomes in exposed and unexposed fetuses, and their 95% confidence intervals were calculated assuming a random effects model. RESULTS: Based on 217 patients exposed to indomethacin and 221 to placebo, the risk of ductal closure was 15-fold higher in the group of women exposed to NSAIDs compared with those receiving either placebo or other NSAIDs (8 studies; OR = 15.04, 95% CI 3.29 to 68.68). There was no significant increased risk of ductal closure in the infants of women treated with indomethacin compared with those receiving other drugs (4 studies; OR = 2.12, 95% CI 0.48 to 9.25). Similar results were found when calculating rate differences. CONCLUSIONS: Short-term use of NSAIDs in late pregnancy is associated with a significant increase in the risk of premature ductal closure.
BACKGROUND: Nonsteroidal antiinflammatory drugs (NSAIDs) are increasingly being used during pregnancy to treat a variety of conditions. An evaluation of the risk of premature closure of the ductus arteriosus is useful in determining the safety of NSAIDs at different stages of pregnancy. OBJECTIVE: To determine whether NSAID use during the third trimester of pregnancy is associated with an increased risk of premature constriction of the ductus arteriosus. METHODS: A systematic review was conducted of MEDLINE (1966-2004), Embase (1980-2004), and the Cochrane Database of Systematic Reviews (1991-2004). Summary estimates of the odds ratios, comparing ductal outcomes in exposed and unexposed fetuses, and their 95% confidence intervals were calculated assuming a random effects model. RESULTS: Based on 217 patients exposed to indomethacin and 221 to placebo, the risk of ductal closure was 15-fold higher in the group of women exposed to NSAIDs compared with those receiving either placebo or other NSAIDs (8 studies; OR = 15.04, 95% CI 3.29 to 68.68). There was no significant increased risk of ductal closure in the infants of women treated with indomethacin compared with those receiving other drugs (4 studies; OR = 2.12, 95% CI 0.48 to 9.25). Similar results were found when calculating rate differences. CONCLUSIONS: Short-term use of NSAIDs in late pregnancy is associated with a significant increase in the risk of premature ductal closure.
Authors: Alexis L Mackiewicz; Gregory W Salyards; Heather K Knych; Ashley E Hill; Kari L Christe Journal: J Am Assoc Lab Anim Sci Date: 2019-06-21 Impact factor: 1.232
Authors: Hanna E Reinebrant; Cynthia Pileggi-Castro; Carla L T Romero; Rafaela A N Dos Santos; Sailesh Kumar; João Paulo Souza; Vicki Flenady Journal: Cochrane Database Syst Rev Date: 2015-06-05
Authors: P Zielinsky; A L Piccoli; J L Manica; L H Nicoloso; H Menezes; A Busato; M R Moraes; J Silva; L Bender; P Pizzato; L Aita; M Alievi; I Vian; L Almeida Journal: J Perinatol Date: 2009-07-30 Impact factor: 2.521