Pregnancy outcomes following quinolone and fluoroquinolone exposure during pregnancy: A systematic review and meta-analysis.

Reprod Toxicol

Izmir Katip Celebi University, Faculty of Medicine, Department of Pharmacology Izmir, Turkey; Terafar, Izmir Katip Celebi University Teratology Information, Training and Research Center, Izmir, Turkey.

Published: April 2019

Objective: To investigate whether maternal exposure to quinolones, fluoroquinolones and specifically ciprofloxacin is associated with major malformations and other adverse pregnancy outcomes.

Methods: MEDLINE/PubMed, Embase and Reprotox® databases were searched. Observational studies with an exposed and control group were included.

Results: Analysis of 8 cohort and 2 case-control studies showed no significant increases in rates of major malformations for quinolone (OR, 1.04; 95% CI 0.89-1.21), fluoroquinolone (RR, 0.89; 95% CI 0.70-1.14) and ciprofloxacin exposure (RR, 0.72; 95% CI 0.43-1.19). For fluoroquinolones, live birth rate was significantly decreased (RD, -0.04; 95% CI -0.08 to -0.01) whereas elective termination rate (RD, 0.04; 95% CI 0.02-0.05) was significantly increased.

Conclusions: Quinolone, fluoroquinolone and ciprofloxacin exposure were not associated with a significant increase in major malformations and adverse pregnancy outcomes, other than significantly decreased live birth rate and increased elective termination rate which may be the indicators of misperceived teratogenic risk.

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http://dx.doi.org/10.1016/j.reprotox.2019.02.002DOI Listing

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