Neuraminidase inhibitor use during pregnancy does not lead to adverse neonatal outcomes

Pregnant women with exposure to neuraminidase-inhibitor medication do not seem to experience adverse neonatal outcomes, reveals a study.

A team of investigators performed a systematic review and meta-analysis to assess the adverse neonatal outcomes associated with exposure to neuraminidase inhibitors during pregnancy. They searched the databases of PubMed, Embase, and Cochrane Library to identify potential studies for inclusion.

Nine cohort studies estimating the association of adverse neonatal outcomes with exposure to neuraminidase-inhibitor drugs during pregnancy met the eligibility criteria.

Exposure to a neuraminidase inhibitor during pregnancy did not result in an elevated risk of congenital malformation (odds ratio [OR], 0.9, 95 percent confidence interval [CI], 0.72‒1.12; p=0.341), low Apgar score (OR, 0.96, 95 percent CI, 0.77‒1.2; p=0.733), or preterm birth (OR, 0.99, 95 percent CI, 0.89‒1.09; p=0.771) compared with nonexposure.

However, pregnant women who were exposed to a neuraminidase inhibitor had a reduced risk of low birth weight (OR, 0.79, 95 percent CI, 0.68‒0.92; p=0.002) and giving birth to a small-for-gestational-age infant (OR, 0.78, 95 percent CI, 0.69‒0.88; p<0.001).

Further analyses limited to oseltamivir exposure revealed results consistent with the overall findings.

“We recommend further studies to investigate this association, which will help clinicians determine whether to prescribe a neuraminidase inhibitor during pregnancy,” the authors said.

Influenza infection could severely endanger pregnant mothers. Antiviral treatment, such as a neuraminidase inhibitor, is often recommended.