Maternal exposure to folate antagonists and susceptibility to congenital heart disease in offspring: A systematic review and meta‐analysis

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Main Authors: Prajjwol Luitel, Rukesh Yadav, Prince Mandal, Niranjan Adhikari, Sujan Paudel, Anish Mudvari
Format: Artículo Open Access
Published: Wiley 2024
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author Prajjwol Luitel
Rukesh Yadav
Prince Mandal
Niranjan Adhikari
Sujan Paudel
Anish Mudvari
author_facet Prajjwol Luitel
Rukesh Yadav
Prince Mandal
Niranjan Adhikari
Sujan Paudel
Anish Mudvari
Prajjwol Luitel
Rukesh Yadav
Prince Mandal
Niranjan Adhikari
Sujan Paudel
Anish Mudvari
collection Wiley Open Access
contents Maternal exposure to folate antagonists and susceptibility to congenital heart disease in offspring: A systematic review and meta‐analysis Prajjwol Luitel Rukesh Yadav Prince Mandal Niranjan Adhikari Sujan Paudel Anish Mudvari British Journal of Clinical Pharmacology AbstractAimsThe objective of this meta‐analysis was to determine whether maternal exposure to folate antagonists is associated with increased rates of congenital heart disease in offspring.MethodsA comprehensive search for articles in the MEDLINE (PubMed) and EMBASE databases published up to 21 August 2023 was performed. The search strategy was not limited by study design but only for articles in the English language.ResultsAnalysis of 6 cohort studies and 5 cross‐sectional studies, published between 1976 and 2020, showed significant increase in rate of congenital heart disease (odds ratio 1.55, 95% confidence interval, 1.28–1.87) when exposed to folate antagonists compared with the control. Further subgroup analysis showed the increased rate for exposure to both dihydrofolate reductase inhibitors and antiepileptic drugs separately. No differences were observed when analyses were stratified by timing of study.ConclusionAdministration of folate antagonists within the 12‐week period preceding conception and throughout the second and third months of gestation exhibited a statistically significant elevation in the susceptibility to congenital heart diseases. Notably, the protective effect of folic acid supplementation was reported in cases of congenital heart disease linked to dihydrofolate reductase inhibitors but not that associated with antiepileptic drugs. 10.1111/bcp.16021 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/bcp.16021
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spellingShingle Maternal exposure to folate antagonists and susceptibility to congenital heart disease in offspring: A systematic review and meta‐analysis
Prajjwol Luitel
Rukesh Yadav
Prince Mandal
Niranjan Adhikari
Sujan Paudel
Anish Mudvari
British Journal of Clinical Pharmacology
Maternal exposure to folate antagonists and susceptibility to congenital heart disease in offspring: A systematic review and meta‐analysis Prajjwol Luitel Rukesh Yadav Prince Mandal Niranjan Adhikari Sujan Paudel Anish Mudvari British Journal of Clinical Pharmacology AbstractAimsThe objective of this meta‐analysis was to determine whether maternal exposure to folate antagonists is associated with increased rates of congenital heart disease in offspring.MethodsA comprehensive search for articles in the MEDLINE (PubMed) and EMBASE databases published up to 21 August 2023 was performed. The search strategy was not limited by study design but only for articles in the English language.ResultsAnalysis of 6 cohort studies and 5 cross‐sectional studies, published between 1976 and 2020, showed significant increase in rate of congenital heart disease (odds ratio 1.55, 95% confidence interval, 1.28–1.87) when exposed to folate antagonists compared with the control. Further subgroup analysis showed the increased rate for exposure to both dihydrofolate reductase inhibitors and antiepileptic drugs separately. No differences were observed when analyses were stratified by timing of study.ConclusionAdministration of folate antagonists within the 12‐week period preceding conception and throughout the second and third months of gestation exhibited a statistically significant elevation in the susceptibility to congenital heart diseases. Notably, the protective effect of folic acid supplementation was reported in cases of congenital heart disease linked to dihydrofolate reductase inhibitors but not that associated with antiepileptic drugs. 10.1111/bcp.16021 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Maternal exposure to folate antagonists and susceptibility to congenital heart disease in offspring: A systematic review and meta‐analysis
topic British Journal of Clinical Pharmacology
url https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.16021