Safety of Mefloquine and Other Antimalarial Agents in the First Trimester of Pregnancy

Phillips‐Howard, Penelope A.; Steffen, Robert; Kerr, Lydia; Vanhauwere, Bart; Schildknecht, Janine; Fuchs, Elisabeth; Edwards, Ralph

doi:10.1111/j.1708-8305.1998.tb00484.x

Cited by 75 publications

(41 citation statements)

References 14 publications

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“…The majority (87.3%) of the abortion cases were reported by three publications. 6,23,24 The analysis by McGready et al found that the risk of spontaneous abortion was similar for woman treated with CQ (26%), quinine (27%), and artesunate (31%). The key finding is that even an episode of asymptomatic and symptomatic malaria can increase the risk for miscarriage by 2.7 times and four times, respectively, compared to women without malaria during pregnancy.…”

Section: Abortions/miscarriagesmentioning

confidence: 99%

“…24 Phillips-Howard et al showed from their analysis that MQ exposure resulted in a significant risk of therapeutically induced abortions compared with SP (26% compared with 7%, relative risk 1.32, 95% confidence interval 1.22-1.44). 23 …”

Section: Abortions/miscarriagesmentioning

confidence: 99%

“…23 Schlagenhauf et al reviewed records held in a pharmaceutical database to investigate the effect of exposure to MQ before or during pregnancy on pregnancy and offspring outcomes. Among 2,139 pregnancies exposed in the first trimester, pregnancy and fetal outcomes were prospectively assessed, while in 227 cases the outcomes were known at the time of reporting.…”

Section: Studies Based On Analyses Of Travel Records or Other Databasesmentioning

confidence: 99%

“…Safety of antimalarials in early pregnancy or therapeutically induced but in one instance 23 it was classified as missed if the fetus died before the 18th week of gestation but was retained in utero. Stillbirth was defined as the delivery after 28 weeks of gestation of a fetus that did not breathe or fetal death after 20 completed weeks of gestation.…”

mentioning

confidence: 99%

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Safety of antimalarial drugs exposure during early pregnancy

Tagbor¹,

Antwi²,

Dogbe³

2014

RRTM

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Introduction:Inadequately controlled malaria infection in pregnancy is associated with poor maternal and fetal outcomes. However, there are important questions about drug safety for mothers with malaria and their fetuses as, currently, there is limited safety data on many of the medications used. The objective of this review is to determine from published evidence the safety of antimalarial drugs exposure during early pregnancy, focusing on abortions, stillbirths, and congenital abnormalities. Methods: We searched PubMed, Embase, Cochrane Library, and Malaria in Pregnancy databases from their inception to June 2013, inclusive, for reports published in English only. Data were extracted on exposure to antimalarial drugs during early pregnancy and adverse pregnancy outcomes including congenital abnormalities, stillbirth, and miscarriage. Results: Twenty-two publications including one abstract with a total of 6,333 early pregnancy exposures to antimalarial agents used for treatment and/or prevention of malaria in pregnancy met the inclusion criteria. More than 40% of the pregnancies were exposed to mefloquine, about 10% to artemisinin based regimens and, 15.2% and 14.7% were exposed to chloroquine and quinine, respectively. A total of 1,199 adverse outcomes including abortions, stillbirths, and congenital abnormalities were reported. The reported absolute risks of adverse outcomes were similar for all the antimalarial exposures, but, in two publications, increased risk of stillbirths was linked to mefloquine exposure. Extensive heterogeneity and variability in the way in which authors assessed, recorded, and reported safety data precluded formal meta-analysis. Conclusion: The absolute estimates of risks obtained in the included studies are difficult to interpret and the clinical significance of any association of adverse outcomes reported with antimalarial exposure in early pregnancy is uncertain. Well planned, executed, and analyzed studies are needed to confirm whether there is increased risk for adverse fetal outcomes attributable to exposure of first trimester pregnancies to antimalarials compared to relevant controls.

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Section: Abortions/miscarriagesmentioning

confidence: 99%

Section: Abortions/miscarriagesmentioning

confidence: 99%

Section: Studies Based On Analyses Of Travel Records or Other Databasesmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Safety of antimalarial drugs exposure during early pregnancy

Tagbor¹,

Antwi²,

Dogbe³

2014

RRTM

View full text Add to dashboard Cite

show abstract

“…However, they might be used for the treatment of uncomplicated malaria caused by CQ-resistant P. falciparum strains if no other treatment options are available, but only if the potential benefit is judged to outweigh the potential risks. Mefloquine has been reported to be safe for children and for pregnant women in the second and third trimester [25], but is associated with an increase of stillbirths in the first trimester [26] and is thus not recommended during pregnancy [16].…”

Section: Treatment Of Benign Plasmodium Falciparum Infectionsmentioning

confidence: 99%