2024, Number 02
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Ginecol Obstet Mex 2024; 92 (02)
Exposure to ondansetron in the first trimester of pregnancy and risk of congenital malformations: systematic review and metaanalysis
Camacho MA, Alfonso AD, Arreaza GM, Molina GS, Buitrago LM
Language: Spanish
References: 27
Page: 69-84
PDF size: 451.97 Kb.
ABSTRACT
Objective: To determine whether ondansetron exposure in the first trimester is
associated with an increased risk of any congenital malformations. As secondary
outcomes, determine if it is associated with a higher overall risk of congenital heart
disease, interventricular septal defects, orofacial malformations, cleft lip defect (with
or without palate) or cleft palate.
Methodology: A systematic review with meta-analysis was carried out. The search
was carried out in the following databases: PUBMED, EMBASE and LILACS, randomized
studies, cohorts and cases and controls were chosen.
Results: 15 studies were included, 11 cohort studies and four case-control studies,
with 245,679 women exposed to ondansetron in the first trimester. No statistically sig-
nificant association was found with overall congenital malformations (OR, 1.1; 95%, CI
0.99–1.22 I2: 72%), nor with congenital heart diseases (OR, 1.05; 95%, CI 0.95–1.19
I2: 78%) not with ventricular septal defects (OR, 1.2 95% CI 0.97 – 1.45 I2: 85%). A
small increased risk was found for overall orofacial defects (OR, 1.17 95% CI 1.04 -
1.32 I2:0%), no increased risk was found for lip defect (with or without palate) (OR,
1.01 CI 95% 0.84 -1.21 I2%: 0%) or cleft palate (OR, 1.16 95% CI 0.9 – 1.5 I2: 31%).
Conclusion: The results show that the use of ondansetron in the first trimester
is not associated with an increase in overall congenital malformations, nor with an
increase in heart disease, cleft lip and/or palate, but there is a slight increase in the
risk of orofacial malformations.
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