Sheehy Odile, Santos Fabiano, Ferreira Ema, Berard Anick
Research Centre CHU Sainte- Justine, 3175 Côte-Sainte-Catherine, Montreal, H3T1C5, Canada.
Curr Drug Saf. 2015;10(2):170-9. doi: 10.2174/157488631002150515124548.
To review the available evidence concerning the relationship between the exposure to metronidazole during pregnancy and the risk of preterm delivery and birth defects.
Studies investigating the association between gestational use of oral metronidazole on human subjects and the risk of preterm birth or/and birth defects were systematically retrieved from MEDLINE and EMBASE databases. We selected studies published in English or French between 1964 and 2012. Where effect estimates were not reported, crude ORs along with 95% confidence intervals were calculated.
We selected 17 studies investigating the association between exposure to oral metronidazole and the risk of preterm birth, from which 12 were randomized clinical trials. In addition, we identified 13 studies devoted to the relationship between metronidazole and birth defects, from which 10 were cohort studies, 1 was a case-control study and 2 were meta-analysis.
During pregnancy, treating bacterial vaginosis and trichomoniasis with metronidazole is effective and offers no teratogen risk. Benefit of metronidazole in the reduction of preterm birth was demonstrated for the combination of this medication with other antibiotics. Additional information is needed when metronidazole is used in association with other agents.
回顾关于孕期暴露于甲硝唑与早产及出生缺陷风险之间关系的现有证据。
从MEDLINE和EMBASE数据库中系统检索研究口服甲硝唑在人类受试者孕期使用情况与早产或/和出生缺陷风险之间关联的研究。我们选取了1964年至2012年间以英文或法文发表的研究。若未报告效应估计值，则计算粗比值比及95%置信区间。
我们选取了17项研究口服甲硝唑暴露与早产风险之间关联的研究，其中12项为随机临床试验。此外，我们确定了13项关于甲硝唑与出生缺陷关系的研究，其中10项为队列研究，1项为病例对照研究，2项为荟萃分析。
孕期使用甲硝唑治疗细菌性阴道病和滴虫病有效且无致畸风险。该药物与其他抗生素联合使用可降低早产风险。甲硝唑与其他药物联用时需要更多信息。
