Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis

Introduction Orofacial clefts (OFCs), including cleft lip, cleft palate and combined cleft lip and palate, are among the most common craniofacial malformations in newborns and present significant healthcare challenges. Emerging evidence has raised concerns regarding the potential impact of prenatal...

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Main Authors: Mahbubur Rahman, Md Shafiur Rahman, Kazunari Onishi, Md Mahfuzur Rahman, Abir Nagata, Takatoshi Nakagawa, Salma Sharmin
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e092019.full
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author Mahbubur Rahman
Md Shafiur Rahman
Kazunari Onishi
Md Mahfuzur Rahman
Abir Nagata
Takatoshi Nakagawa
Salma Sharmin
author_facet Mahbubur Rahman
Md Shafiur Rahman
Kazunari Onishi
Md Mahfuzur Rahman
Abir Nagata
Takatoshi Nakagawa
Salma Sharmin
author_sort Mahbubur Rahman
collection DOAJ
description Introduction Orofacial clefts (OFCs), including cleft lip, cleft palate and combined cleft lip and palate, are among the most common craniofacial malformations in newborns and present significant healthcare challenges. Emerging evidence has raised concerns regarding the potential impact of prenatal exposure to antibiotics on fetal development. Antibiotics prescribed during pregnancy—particularly those that cross the placental barrier—may pose teratogenic risks. Previous studies investigating the association between prenatal antibiotic exposure and the risk of OFCs have yielded inconsistent results. However, no studies have yet attempted to summarise this evidence, highlighting the need for a comprehensive evaluation. This report describes a systematic review and meta-analysis protocol to retrospectively analyse the relationship between prenatal antibiotic exposure and the risk of developing OFCs, focusing on the role of antibiotic type and timing of exposure. The results of such a review will hopefully provide a comprehensive synthesis of the available evidence, helping to inform clinical practice and guide patient counselling regarding the use of antibiotics during pregnancy.Methods and analysis The planned systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines to ensure a comprehensive and systematic approach to summarising the available evidence on the topic. This study will include longitudinal cohort studies, case–control studies, and interventional trials that investigate the association between prenatal antibiotic exposure and OFCs. The search strategy will cover major databases, including CINAHL, Cochrane Library, ClinicalTrials.gov, EMBASE, PubMed, Scopus and Web of Science, using tailored search terms. A team of independent assessors will screen article titles, abstracts and full texts. Any discrepancies will be resolved through discussions. Quality assessment will use the Newcastle-Ottawa Scale and Grading of Recommendations Assessment, Development and Evaluation criteria. Data extraction will focus on the study characteristics, participant details, exposure specifics and outcome measures. A random-effects meta-analysis will aggregate summary effect sizes, and heterogeneity will be assessed using I2 and Q statistics.Ethics and dissemination Ethical approval is not required for this systematic review, as it relies on already published data. The findings will be disseminated through peer-reviewed journals and conference presentations, providing critical insights into clinical practice and public health policies regarding antibiotic use during pregnancy.PROSPERO registration number CRD42024565064
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spelling doaj-art-9d76d933d74640bfbf92556493a469822025-08-20T02:22:40ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-092019Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysisMahbubur Rahman0Md Shafiur Rahman1Kazunari Onishi2Md Mahfuzur Rahman3Abir Nagata4Takatoshi Nakagawa5Salma Sharmin64 Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo, Japan2 School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan4 Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo, Japan4 Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo, Japan1 Graduate School of Medicine, Osaka University, Suita, Osaka, Japan1 Graduate School of Medicine, Osaka University, Suita, Osaka, Japan5 Department of Dental Public Health, University Dental College and Hospital, Dhaka, BangladeshIntroduction Orofacial clefts (OFCs), including cleft lip, cleft palate and combined cleft lip and palate, are among the most common craniofacial malformations in newborns and present significant healthcare challenges. Emerging evidence has raised concerns regarding the potential impact of prenatal exposure to antibiotics on fetal development. Antibiotics prescribed during pregnancy—particularly those that cross the placental barrier—may pose teratogenic risks. Previous studies investigating the association between prenatal antibiotic exposure and the risk of OFCs have yielded inconsistent results. However, no studies have yet attempted to summarise this evidence, highlighting the need for a comprehensive evaluation. This report describes a systematic review and meta-analysis protocol to retrospectively analyse the relationship between prenatal antibiotic exposure and the risk of developing OFCs, focusing on the role of antibiotic type and timing of exposure. The results of such a review will hopefully provide a comprehensive synthesis of the available evidence, helping to inform clinical practice and guide patient counselling regarding the use of antibiotics during pregnancy.Methods and analysis The planned systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines to ensure a comprehensive and systematic approach to summarising the available evidence on the topic. This study will include longitudinal cohort studies, case–control studies, and interventional trials that investigate the association between prenatal antibiotic exposure and OFCs. The search strategy will cover major databases, including CINAHL, Cochrane Library, ClinicalTrials.gov, EMBASE, PubMed, Scopus and Web of Science, using tailored search terms. A team of independent assessors will screen article titles, abstracts and full texts. Any discrepancies will be resolved through discussions. Quality assessment will use the Newcastle-Ottawa Scale and Grading of Recommendations Assessment, Development and Evaluation criteria. Data extraction will focus on the study characteristics, participant details, exposure specifics and outcome measures. A random-effects meta-analysis will aggregate summary effect sizes, and heterogeneity will be assessed using I2 and Q statistics.Ethics and dissemination Ethical approval is not required for this systematic review, as it relies on already published data. The findings will be disseminated through peer-reviewed journals and conference presentations, providing critical insights into clinical practice and public health policies regarding antibiotic use during pregnancy.PROSPERO registration number CRD42024565064https://bmjopen.bmj.com/content/14/11/e092019.full
spellingShingle Mahbubur Rahman
Md Shafiur Rahman
Kazunari Onishi
Md Mahfuzur Rahman
Abir Nagata
Takatoshi Nakagawa
Salma Sharmin
Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
BMJ Open
title Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
title_full Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
title_fullStr Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
title_full_unstemmed Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
title_short Prenatal exposure to antibiotics and the risk of orofacial clefts: a protocol for a systematic review and meta-analysis
title_sort prenatal exposure to antibiotics and the risk of orofacial clefts a protocol for a systematic review and meta analysis
url https://bmjopen.bmj.com/content/14/11/e092019.full
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