School of Public Health, University of Washington, Seattle, Washington, USA.
Center for Vaccine Innovation and Access, PATH, Seattle, Washington, USA.
BMJ Open. 2023 May 8;13(5):e070543. doi: 10.1136/bmjopen-2022-070543.
Data regarding the safety of drugs and vaccines in pregnant women are typically unavailable before licensure. Pregnancy exposure registries (PERs) are an important source of postmarketing safety information. PERs in low-income and middle-income countries (LMICs) are uncommon but can provide valuable safety data regarding their distinct contexts and will become more relevant as the introduction and use of new drugs and vaccines in pregnancy increase worldwide. Strategies to support PERs in LMICs must be based on a better understanding of their current status. We developed a scoping review protocol to assess the landscape of PERs that operate in LMICs and characterise their strengths and challenges.
This scoping review protocol follows the Joanna Briggs Institute manual for scoping reviews. The search strategy will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. We will search PubMed, Embase, CINAHL and WHO's Global Index Medicus, as well as the reference lists of retrieved full-text records, for articles published between 2000 and 2022 that describe PERs or other resources that systematically record exposures to medical products during pregnancy and maternal and infant outcomes in LMICs. Title and abstracts will be screened by two authors and data extracted using a standardised form. We will undertake a grey literature search using Google Scholar and targeted websites. We will distribute an online survey to selected experts and conduct semistructured interviews with key informants. Identified PERs will be summarised in tables and analysed.
Ethical approval is not required for this activity, as it was determined not to involve human subjects research. Findings will be submitted to an open access peer-reviewed journal and may be presented at conferences, with underlying data and other materials made publicly available.
在获得许可之前,通常无法获得有关孕妇用药和疫苗安全性的数据。妊娠暴露登记处(PERs)是上市后安全性信息的重要来源。在低收入和中等收入国家(LMICs)中,PERs 并不常见,但可以提供有关其独特背景的有价值的安全性数据,并且随着全球范围内新药物和疫苗在妊娠中的引入和使用的增加,它们将变得更加相关。支持 LMICs 中的 PERs 的策略必须基于对其现状的更好理解。我们制定了一个范围综述方案,以评估在 LMICs 中运作的 PERs 的现状,并描述其优势和挑战。
本范围综述方案遵循 Joanna Briggs 研究所的范围综述手册。搜索策略将使用系统评价和荟萃分析扩展的首选报告项目清单进行报告,以涵盖范围综述清单。我们将在 2000 年至 2022 年期间,在 PubMed、Embase、CINAHL 和世界卫生组织的全球医学索引中,以及检索到的全文记录的参考文献中,搜索描述 LMICs 中 PERs 或其他系统记录妊娠期间药物暴露和母婴结局资源的文章。两名作者将筛选标题和摘要,并使用标准化表格提取数据。我们将使用 Google Scholar 和有针对性的网站进行灰色文献搜索。我们将向选定的专家发送在线调查,并对主要知情人进行半结构化访谈。确定的 PERs 将以表格形式总结,并进行分析。
这项活动不需要伦理批准,因为它被确定不涉及人类受试者研究。研究结果将提交给开放获取的同行评审期刊,并可能在会议上展示,基础数据和其他材料将公开提供。