AIM: Influenza infection poses a severe threat to pregnant mothers, and
antiviral treatment is recommended. However, the safety of
neuraminidase-inhibitor antiviral medications during pregnancy has not
been well described. METHODS: A systematic review and meta-analysis were
performed to evaluate the adverse neonatal outcomes associated with
exposure to neuraminidase inhibitors during pregnancy. The PubMed,
Embase, and Cochrane Library databases were searched to identify
potential studies for inclusion. RESULTS: Nine cohort studies that
estimated adverse neonatal outcomes associated with exposure to
neuraminidase-inhibitor medication during pregnancy were included.
Exposure to a neuraminidase inhibitor during pregnancy was not
associated with an increased risk of congenital malformation (odds ratio
[OR] 0.9, 95% confidence interval [CI] 0.72–1.12, P = 0.341),
low Apgar score (OR 0.96, 95% CI 0.77–1.2, P = 0.733), or preterm
birth (OR 0.99, 95% CI 0.89–1.09, P = 0.771) compared with no
exposure. However, exposure to a neuraminidase inhibitor was associated
with a reduced risk of low birth weight (OR 0.79, 95% CI 0.68–0.92, P
= 0.002) and giving birth to a small-for-gestational-age infant (OR
0.78, 95% CI 0.69–0.88, P < 0.001). Further analyses limited
to oseltamivir exposure were consistent with the overall results.
CONCLUSION: Exposure to neuraminidase-inhibitor medication during
pregnancy does not appear to be associated with adverse neonatal
outcomes. We recommend further studies to investigate this association,
which will help clinicians determine whether to prescribe a
neuraminidase inhibitor during pregnancy.
Neonatal outcomes after neuraminidase inhibitor use during pregnancy: a meta‐analysis of cohort studies
