Adverse Effect of Diclofenac Exposure during Pregnancy on Mother and Fetus; A Systematic Review

Abstract

INTRODUCTION Since 1974, diclofenac has been used to treat the pain and swelling associated with rheumatic illnesses as a non-steroid anti-inflammatory medication (NSAID). It is one among the world's most extensively used non-steroidal anti-inflammatory medications (NSAIDs). Non-steroidal anti-inflammatory medicines have been shown to cause embryotoxicity and teratogenicity in experimental animals in a few studies, however there is no strong evidence of this impact in people. The aim of this study was to conduct a systematic assessment of the effects of diclofenac exposure on the mother and fetus during pregnancy. METHODS This study included all experimental, quasi-experimental, and observational research that were published in the English language and published up to the date of the review. PROSPERO (The International Prospective Register of Systematic Reviews) ID=CRD42019135608 was used to register the protocol. This study employed a three-step search technique. PubMed, Medline, SCOPUS, Web of Science, Embase, cinihal, Google, several university repositories, and Google scholar were among the databases searched. The titles and abstracts were then examined by two independent reviewers to see if they met the review's inclusion criteria. At the study level, two independent reviewers critically assessed eligible studies. The review's methodological quality was assessed at the result level using standardized critical assessment instruments from the Joanna Briggs Institute (JBI) for observational studies. Specific details about the demographics, study procedures, interventions, and outcomes of significance to the review purpose are included in the data retrieved from the studies. Due to the conclusion and type of the data, statistical pooling was not viable. As a result, the results were presented in a narrative format. RESULTS A total of 1,490,679 participants were found in three relevant papers (two cohorts and nested case-control studies). Diclofenac exposure during pregnancy raises the chance of low birth weight in the fetus, as well as the risk of spontaneous abortion and vaginal bleeding in the mother. CONCLUSIONS Diclofenac exposure during pregnancy has negative consequences on the fetus and the mother. As a result, taking Diclofenac during pregnancy may have negative consequences for both the mother and the fetus, and more primary Randomized Control Trials (RCTs) are needed.