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Systematic review and meta-analyses

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Authors:
  • Dreier, Julie Werenberg ;
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    Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark; and.
  • Andersen, Anne-Marie Nybo ;
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    Orcid logo0000-0002-4296-8488
    Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet
  • Berg-Beckhoff, Gabriele
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    unknown
Subtitle:
Fever in pregnancy and health impacts in the offspring
DOI:
10.1542/peds.2013-3205
Abstract:
BACKGROUND AND OBJECTIVE: Fever during pregnancy has been suspected to harm the developing fetus. However, until now, no systematic analysis of the available evidence has been undertaken to assess the impact of maternal fever on health outcomes in the child. The goal of this study was to systematically review evidence from epidemiologic studies on adverse health outcomes of the offspring in relation to exposure to maternal fever during pregnancy. METHODS: Systematic searches in PubMed, Web of Science, and the Cochrane Library were performed by using Medical Subject Headings, Boolean operators, and truncation, and references of references were reviewed. Cohort and case-control studies addressing health outcomes of prenatal fever exposure in humans were eligible for inclusion. Studies with no direct reference to fever, studies in selected populations (eg, preterm births), and studies published before 1990 were excluded. RESULTS: The available literature supported an increased risk of adverse offspring health in association with fever during pregnancy. The strongest evidence was available for neural tube defects, congenital heart defects, and oral clefts, in which meta-analyses suggested between a 1.5- and nearly 3-fold increased risk with fever exposure in the first trimester. We did not find strong evidence of a dose-response relationship, but there was some evidence that antipyretic medications may have a protective effect when used in relation to febrile episodes. CONCLUSIONS: We found substantial evidence to support the contention that maternal fever during pregnancy may negatively affect offspring health. The harmful effects seemed to cover both short- and longer-term health outcomes; however, for several outcomes, the evidence was insufficient to judge any association.
Type:
Journal article
Language:
English
Published in:
Pediatrics (english Edition), 2014, Vol 133, Issue 3
Keywords:
Case-Control Studies; Cleft Lip; Cohort Studies; Female; Fever; Heart Defects, Congenital; Humans; Infant, Newborn; Neural Tube Defects; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2014
Scientific Level:
Scientific
ID:
260478800

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