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Does the use of bisphosphonates during pregnancy affect fetal outcomes? A systematic review

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Abstract

Purpose

This systematic review aimed to determine the effects of maternal exposure to bisphosphonates (BPs) during pregnancy on neonatal outcomes. It aimed to disclosfe the impact of BPs on neonates and identify aspects that require further investigation.

Methods

A comprehensive search of PubMed, Science Direct, LILACS, EMBASE, and Web of Science was conducted until August 2022, with no time restrictions. The selection criteria included studies published in English that evaluated pregnant women who were exposed to BPs.

Results

From an initial pool of 2169 studies, 13 met the inclusion criteria for this systematic review. These studies collectively included 106 women (108 pregnancies) who were exposed to BPs either before orduring pregnancy. A summary of the key characteristics of the selected studies and the risk of bias assessment are provided. Exposure to BPs occurs at various stages of pregnancy, with different indications for BP treatment. The most frequently reported neonatal outcomes were spontaneous abortion, congenital malformations, hypocalcemia, preterm birth, and low birth weight.

Conclusion

Although previous reports have linked BPs before or during pregnancy with adverse neonatal outcomes, these associations should be interpreted with caution. Given the complexity of these findings, further research is necessary to provide more definitive insights to guide clinical decisions regarding the use of BPs in pregnant women.

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Data availability

All data supporting the findings of this study are available within the paper and its Supplementary Information.

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Authors and Affiliations

  1. Department of Oral Medicine, School of Dentistry, University of São Paulo, São Paulo, Brazil

    Wladimir Gushiken de Campos, Vinícius Teixeira & Celso Augusto Lemos

  2. BoneLab - Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393, Porto, Portugal

    Rita Araújo & Pedro Sousa Gomes

  3. LAQV/REQUIMTE, University of Porto, Porto, Portugal

    Rita Araújo & Pedro Sousa Gomes

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  1. Wladimir Gushiken de Campos
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  2. Rita Araújo
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  3. Vinícius Teixeira
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  4. Pedro Sousa Gomes
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  5. Celso Augusto Lemos
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Contributions

WG, VT, RA, PG AND CAL wrote the main manuscript text and WG prepared figures 1-3. WG, VT, RA conducted the general review. All authors reviewed and approved the manuscript.

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Correspondence to Wladimir Gushiken de Campos.

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de Campos, W.G., Araújo, R., Teixeira, V. et al. Does the use of bisphosphonates during pregnancy affect fetal outcomes? A systematic review. Eur J Clin Pharmacol (2024). https://doi.org/10.1007/s00228-024-03693-7

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