Risk of teratogenicity in continued pregnancy after gestational exposure to mifepristone and/or misoprostol: a systematic review and meta-analysis.

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 8710213 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0711 (Electronic) Linking ISSN: 09320067 NLM ISO Abbreviation: Arch Gynecol Obstet Subsets: MEDLINE

Publication: Berlin : Springer Verlag
Original Publication: München : Springer International, c1987-

Misoprostol*/adverse effects ; Misoprostol*/administration & dosage ; Mifepristone*/adverse effects ; Mifepristone*/administration & dosage ; Abnormalities, Drug-Induced*/epidemiology ; Abnormalities, Drug-Induced*/etiology; Humans ; Pregnancy ; Female ; Infant, Newborn ; Abortifacient Agents, Steroidal/adverse effects ; Abortifacient Agents, Steroidal/administration & dosage ; Abortifacient Agents, Nonsteroidal/adverse effects

Purpose: This meta-analysis aimed to comprehensively assess the teratogenic risk to offspring associated with continuing pregnancy after administering mifepristone and/or misoprostol during gestation.
Methods: We conducted a systematic search of multiple databases, including PubMed, Web of Science, Embase, Cochrane, CNKI, and CBM, from their inception to February 2024, with no language restrictions. We included cohort and case-control studies that analyzed the teratogenic effects of mifepristone and/or misoprostol on fetuses and newborns. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The odds ratios (OR) from individual studies were combined using meta-analysis. Sensitivity testing and heterogeneity analysis were conducted.
Results: A total of 13 studies were eligible for inclusion, comprising 5193 cases of congenital malformations and 12,232 controls.
Conclusion: Our findings indicated that the use of misoprostol during early pregnancy increased the risk of congenital abnormalities in offspring (OR = 2.69; 95% CI: 1.57-4.62). However, the potential teratogenic effect of mifepristone during pregnancy cannot be ruled out. Additionally, the use of mifepristone and/or misoprostol has been linked to a higher risk of certain congenital anomalies, such as hydrocephalus (OR = 3.41; 95% CI: 1.17-9.97), Möbius syndrome (OR = 26.48; 95% CI: 11.30-62.01), and terminal transverse limb defects (OR = 10.75; 95% CI: 3.93-29.41). (PROSPERO, CRD42024522093, 03182024).
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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Keywords: Congenital abnormalities; Gestational exposure; Medical abortion; Mifepristone; Misoprostol

0E43V0BB57 (Misoprostol)
320T6RNW1F (Mifepristone)
0 (Abortifacient Agents, Steroidal)
0 (Abortifacient Agents, Nonsteroidal)

Date Created: 20240709 Date Completed: 20240902 Latest Revision: 20241115

20241115

10.1007/s00404-024-07616-w

38980347