Risks of miscarriage and inadvertent exposure to artemisinin derivatives in the first trimester of pregnancy: a prospective cohort study in western KenyaReportar como inadecuado




Risks of miscarriage and inadvertent exposure to artemisinin derivatives in the first trimester of pregnancy: a prospective cohort study in western Kenya - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal Title:

Malaria Journal

Volume:

Volume 14, Number 1

Publisher:

BioMed Central | 2015-11-18, Pages 461-461

Type of Work:

Article | Final Publisher PDF

Abstract: Background: The artemisinin anti-malarials are widely deployed as artemisinin-based combination therapy ACT. However, they are not recommended for uncomplicated malaria during the first trimester because safety data from humans are scarce. Methods: This was a prospective cohort study of women of child-bearing age carried out in 2011-2013, evaluating the relationship between inadvertent ACT exposure during first trimester and miscarriage. Community-based surveillance was used to identify 1134 early pregnancies. Cox proportional hazard models with left truncation were used. Results: The risk of miscarriage among pregnancies exposed to ACT confirmed + unconfirmed in the first trimester, or during the embryo-sensitive period ≥6 to <13 weeks gestation was higher than among pregnancies unexposed to anti-malarials in the first trimester: hazard ratio HR = 1.70, 95 % CI 1.08-2.68 and HR = 1.61 0.96-2.70. For confirmed ACT-exposures primary analysis the corresponding values were: HR = 1.24 0.56-2.74 and HR = 0.73 0.19-2.82 relative to unexposed women, and HR = 0.99 0.12-8.33 and HR = 0.32 0.03-3.61 relative to quinine exposure, but the numbers of quinine exposures were very small. Conclusion: ACT exposure in early pregnancy was more common than quinine exposure. Confirmed inadvertent artemisinin exposure during the potential embryo-sensitive period was not associated with increased risk of miscarriage. Confirmatory studies are needed to rule out a smaller than three-fold increase in risk.

Subjects: Health Sciences, Pharmacology - Health Sciences, Public Health - Health Sciences, Obstetrics and Gynecology - Research Funding: This work was partly supported by the Malaria in Pregnancy MiP Consortium, which is funded through a grant from the Bill and Melinda Gates Foundation to the Liverpool School of Tropical Medicine, UK and partly by the US Centers for Disease Control and Prevention CDC, Division of Parasitic Diseases and Malaria through a cooperative agreement with Kenya Medical Research Institute KEMRI, Center for Global Health Research CGHR, Kisumu, Kenya.

Keywords: Science and Technology - Life Sciences and Biomedicine - Infectious Diseases - Parasitology - Tropical Medicine - Anti-malarials - Pharmacovigilance - Drug safety in pregnancy - Teratogenicity - Miscarriage - ARTEMETHER-LUMEFANTRINE - MORBIDITY SURVEILLANCE - DEVELOPMENTAL TOXICITY - ANTIMALARIAL-DRUG - BIRTH-WEIGHT - SAFETY - MALARIA - WOMEN - ARTESUNATE - HEALTH -



Autor: Stephanie Dellicour, Meghna Desai, George Aol, Martina Oneko, Peter Ouma, Godfrey Bigogo, Deron C. Burton, Robert Breiman, Mary J

Fuente: https://open.library.emory.edu/



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