SynthesisJournal of acquired immune deficiency syndromes (1999)2014
Safety of cotrimoxazole in pregnancy: a systematic review and meta-analysis.
Synthesis in Journal of acquired immune deficiency syndromes (1999), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Pooled it
- Co-trimoxazole-induced reproductive toxicity and placental-barrier disruption: impact on cell-cell junctions and ERK signaling pathway.Frontiers in cell and developmental biology · 2026Article
- Research progress on clinical challenges and prevention strategies of drug-resistantFrontiers in public health · 2026Review
- Planning a pregnancy after lung transplantation: Issues and considerations.Obstetric medicine · 2025Article
- Navigating Q fever: Current perspectives and challenges in outbreak preparedness.Open veterinary journal · 2024Review
- Impact of lactoferrin supplementation on cotrimoxazole pharmacokinetics: A preliminary clinical investigation.ADMET & DMPK · 2024Article
- Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil.PLoS neglected tropical diseases · 2023Article
- Effect of Antimicrobial Exposure in Pregnancy on Adverse Pregnancy Outcomes and Admission Rate to the Neonatal Intensive Care Unit: A Multi-Center Cohort Study.Infection and drug resistance · 2023Article
- Coxiellosis in Livestock: Epidemiology, Public Health Significance, and Prevalence ofVeterinary medicine (Auckland, N.Z.) · 2023Review
- Article
- Genetic characterization of co-trimoxazole non-susceptibleAccess microbiology · 2021Article
- Q Fever in the First Trimester: A Case Report from Northern Rural New South Wales.Tropical medicine and infectious disease · 2019Article
- Use of trimethoprim-sulfamethoxazole during pregnancy and risk of spontaneous abortion: a nested case control study.British journal of clinical pharmacology · 2018Article
- Prevalence of vulvovaginal candidiasis in gynecological practices in Germany: A retrospective study of 954,186 patients.Current medical mycology · 2018Article
- Cost-effectiveness of malaria preventive treatment for HIV-infected pregnant women in sub-Saharan Africa.Malaria journal · 2017Article
- Article
- Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania.Drug, healthcare and patient safety · 2016Article
- Dose Dependent Effect of Sulfamethoxazole on Inhibiting KDose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
introductionCotrimoxazole is widely prescribed to treat a range of infections, and for HIV-infected individuals it is administered as prophylaxis to protect against opportunistic infections. Some reports suggest that fetuses exposed to cotrimoxazole during early pregnancy may have an increased risk of congenital anomalies. We carried out this systematic review to update the evidence of cotrimoxazole safety in pregnancy.
methodsThree databases and 1 conference abstract site were searched in duplicate up to October 31, 2013, for studies reporting adverse maternal and infant outcomes among women receiving cotrimoxazole during pregnancy. This search was updated in MEDLINE via PubMed to April 28, 2014. Studies were included irrespective of HIV infection status or the presence of other coinfections. Our primary outcome was birth defects of any kind. Secondary outcomes included spontaneous abortions, terminations of pregnancy, stillbirths, preterm deliveries, and drug-associated toxicity.
resultsTwenty-four studies were included for review. There were 232 infants with congenital anomalies among 4196 women receiving cotrimoxazole during pregnancy, giving an overall pooled prevalence of 3.5% (95% confidence interval: 1.8% to 5.1%; τ² = 0.03). Three studies reported 31 infants with neural tube defects associated with first trimester exposure to cotrimoxazole, giving a crude prevalence of 0.7% (95% confidence interval: 0.5% to 1.0%) with most data (29 neural tube defects) coming from a single study. The majority of adverse drug reactions were mild. The quality of the evidence was very low.
conclusionsThe findings of this review support continued recommendations for cotrimoxazole as a priority intervention for HIV-infected pregnant women. It is critical to improve data collection on maternal and infant outcomes.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.