Overall congenital malformations
A meta-analysis of seven studies assessing the risk of congenital
malformations concerning neuraminidase-inhibitor exposure during
pregnancy indicated that the combined OR of congenital malformation risk
was 0.9 (95% CI 0.72–1.12, P = 0.341) (Figure 2). No heterogeneity was
observed among the studies (I2 = 0%, P = 0.852). As
shown in Figure S1, we did not observe any evidence of publication bias
(Begg’s test, P = 1; Egger’s test, P = 0.63). The sensitivity analyses
revealed no substantial change in the pooled risk estimates upon the
exclusion of any single study from the same database. Six studies
reported the risk of congenital malformations in relation to oseltamivir
exposure during pregnancy; the combined OR was 0.89 (95% CI 0.69–1.14,
P = 0.361; I2 = 0%) (Figure S2).
We also analyzed the association between neuraminidase-inhibitor
exposure and heart malformations, which was reported by two studies. The
rates of heart malformations (OR 1.11, 95% CI 0.61–2.03, P = 0.735;
I2 = 0%) (Figure S3) were similar in the two groups.