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Title: The effect of maternal use of macrolides, antifungals, and antivirals/antiretrovirals on non-syndromic orofacial clefts : a systematic review and meta-analysis
Author: Alsaffar, Zainab M.
ISNI:       0000 0004 9359 5532
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2020
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Objective: To assess the risk of non-syndromic orofacial cleft after exposure to macrolides, antifungals, and antivirals/ antiretrovirals during pregnancy. Search Strategy: MEDLINE, EMBASE, and the Cochrane library were searched up to April 30, 2019. Search Criteria: Relevant English language studies investigating foetal adverse outcomes after in utero exposure to macrolides, antifungals, and antivirals/ antiretrovirals. Data Collection and Analysis: Studies were screened by two reviewers. Data was extracted, study quality was assessed, and pooled estimates were calculated. A random effects meta-analysis was conducted to estimate the effect of macrolides and antifungals on the risk of developing a cleft. Antivirals/ antiretrovirals were not included in the meta-analysis as it was not possible to extract the data from the papers identified. Main Results: Overall, nine case-control studies and eight cohort studies met the inclusion criteria. Eight of the seventeen studies were included in the meta-analysis having excluded those pertaining to antivirals/ antiretrovirals and limiting to those measures that were either an “Odds Ratio” or “Prevalence Odds Ratio”. The data indicated that erythromycin and fluconazole exposure during pregnancy is not associated with an increased risk of cleft lip and palate. For antivirals and antiretrovirals, no conclusion could be reached due to the high level of heterogeneity within the studies. ii Conclusions: Exposure to macrolides and antifungals was not associated with an increased risk of oral cleft. Further studies are required to investigate whether antivirals and antiretrovirals pose a risk during pregnancy.
Supervisor: Ireland, Tony Sponsor: Not available
Qualification Name: Thesis (D.D.S.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available