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Azoles (local routes only)
Overall results
Study description
Excluded studies
Table
Graphic
auto
during pregnancy (anytime or not specified)
1st trimester
2nd trimester
3rd trimester
2nd and/or 3rd trimester
throughout pregnancy
early pregnancy
days before delivery
late pregnancy
preconception-only
periconceptional
preconceptional for kinetic reason
at least 1st trimester
3 months (or more) before pregnancy or during pregnancy
1st and 2nd trimester
3 months or more before pregnancy or1st trimester
Whatever the period exposition
individual studies
Outcome
TE
95% CI
n cases
n exposed
k
Pub. bias
Congenital malformations
All congenital malformations (majors, minors, majors and minors, or unspecified)
Rosa - Clotrimazole, 1987 Czeizel - Clotrimazole, 1999 Jick - Azole (Topical route), 1999 Rotem - Clotrimazole (Vaginal), 2018 Zhu - Azoles (Local routes), 2020 Araujo - Sertaconazole (Topical), 2022
6
1.05
[
1.01
; 1.09]
95,494
86,412
not evaluable
Congenital heart defects
Czeizel - Clotrimazole, 1999 Jick - Azole (Topical route), 1999 Carter - Clotrimazole, 2008 Rotem - Clotrimazole (Vaginal), 2018 Zhu - Azoles (Local routes), 2020
5
1.06
[
0.99
; 1.14]
25,923
85,124
not evaluable
Cleft lip with or without cleft palate
Czeizel - Clotrimazole, 1999 Carter - Clotrimazole, 2008 Rotem - Clotrimazole (Vaginal), 2018 Zhu - Azoles (Local routes), 2020
4
0.94
[
0.68
; 1.28]
3,000
84,606
not evaluable
Major congenital malformations
Jick - Azole (Topical route), 1999 Czeizel - Clotrimazole, 1999 Rotem - Clotrimazole (Vaginal), 2018 Araujo - Sertaconazole (Topical), 2022
4
1.02
[
0.92
; 1.13]
24,457
3,236
not evaluable
Limb defects
Jick - Azole (Topical route), 1999 Rotem - Clotrimazole (Vaginal), 2018 Zhu - Azoles (Local routes), 2020
3
1.06
[
0.96
; 1.17]
9,701
84,575
not evaluable
Ano-rectal atresia and stenosis
Kazy b - Metronidazole (Vaginal), 2005 Carter - Clotrimazole, 2008
2
2.04
[
0.38
; 10.88]
429
106
not evaluable
Cleft palate
Czeizel - Clotrimazole, 1999 Zhu - Azoles (Local routes), 2020
2
0.88
[
0.65
; 1.19]
1,643
82,590
not evaluable
Ear malformations
Czeizel - Clotrimazole, 1999 Zhu - Azoles (Local routes), 2020
2
1.29
[
0.88
; 1.88]
786
82,590
not evaluable
Gastroschisis
Czeizel - Clotrimazole, 1999 Carter - Clotrimazole, 2008
2
1.40
[
0.22
; 8.96]
658
508
not evaluable
Genital anomalies
Czeizel - Clotrimazole, 1999 Zhu - Azoles (Local routes), 2020
2
1.06
[
0.95
; 1.18]
7,765
82,590
not evaluable
Hypospadias
Czeizel - Clotrimazole, 1999 Carter - Clotrimazole, 2008
2
1.04
[
0.66
; 1.64]
3,171
541
not evaluable
Nervous system anomalies
Rotem - Clotrimazole (Vaginal), 2018 Zhu - Azoles (Local routes), 2020
2
1.04
[
0.89
; 1.20]
4,572
84,083
not evaluable
Neural Tube Defects
Medveczky - Clotrimazole, 2004 Carter - Clotrimazole, 2008
2
0.92
[
0.48
; 1.78]
1,952
254
not evaluable
Oro-facial clefts
Jick - Azole (Topical route), 1999 Zhu - Azoles (Local routes), 2020
2
0.91
[
0.73
; 1.13]
2,293
82,582
not evaluable
Polydactyly
Jick - Azole (Topical route), 1999 Czeizel - Clotrimazole, 1999
2
1.21
[
0.61
; 2.38]
1,378
1,010
not evaluable
Atrial septal defect
Zhu - Azoles (Local routes), 2020
1
0.99
[
0.85
; 1.17]
3,690
82,090
not evaluable
Atrioventricular septal defect
Zhu - Azoles (Local routes), 2020
1
1.33
[
0.89
; 1.98]
456
82,090
not evaluable
Bilateral renal agenesis including Potter syndrome
Czeizel - Clotrimazole, 1999
1
0.60
[
0.04
; 9.66]
54
498
not evaluable
Club foot / Talipes equinovarus
Czeizel - Clotrimazole, 1999
1
1.14
[
0.68
; 1.92]
2,009
530
not evaluable
Craniosynostosis
Carter - Clotrimazole, 2008
1
3.06
[
0.63
; 14.78]
447
9
not evaluable
Diaphragmatic hernia
Carter - Clotrimazole, 2008
1
1.33
[
0.07
; 23.69]
275
7
not evaluable
Digestive system anomalies
Rotem - Clotrimazole (Vaginal), 2018
1
1.30
[
0.64
; 2.63]
307
1,993
not evaluable
Eye defects
Zhu - Azoles (Local routes), 2020
1
1.07
[
0.77
; 1.50]
802
82,090
not evaluable
Hydrocephaly
Czeizel - Clotrimazole, 1999
1
1.67
[
0.27
; 10.30]
284
503
not evaluable
Limb reduction defects (LRD)
Czeizel - Clotrimazole, 1999
1
1.03
[
0.36
; 2.97]
448
507
not evaluable
Microcephaly / Small head circumference for gestational age
Abdel-Salam - Clotrimazole, 2000
1
0.30
[
0.11
; 0.85]
109
45
not evaluable
Oesophageal atresia with or without tracheo-oesophageal fistula
Kazy b - Metronidazole (Vaginal), 2005
1
7.00
[
0.72
; 68.48]
217
102
not evaluable
Patent ductus arterious
Zhu - Azoles (Local routes), 2020
1
1.11
[
0.89
; 1.37]
1,862
82,090
not evaluable
Respiratory system anomalies
Zhu - Azoles (Local routes), 2020
1
1.08
[
0.93
; 1.24]
4,399
82,090
not evaluable
Spina bifida
Jick - Azole (Topical route), 1999
1
0.66
[
0.03
; 13.81]
2
492
not evaluable
Tetralogy of Fallot
Zhu - Azoles (Local routes), 2020
1
1.43
[
1.04
; 1.96]
696
82,090
not evaluable
Total anomalous pulm venous return
Zhu - Azoles (Local routes), 2020
1
0.93
[
0.55
; 1.55]
385
82,090
not evaluable
Transposition of the great vessels
Zhu - Azoles (Local routes), 2020
1
0.80
[
0.53
; 1.19]
743
82,090
not evaluable
Urinary malformations
Zhu - Azoles (Local routes), 2020
1
1.08
[
0.95
; 1.23]
5,324
82,090
not evaluable
Ventricular septal defect
Zhu - Azoles (Local routes), 2020
1
1.10
[
0.99
; 1.22]
7,886
82,090
not evaluable
Growth parameters and prematurity
Preterm (< 37 weeks)
Araujo - Sertaconazole (Topical), 2022
1
1.06
[
0.96
; 1.18]
-
16,222
not evaluable
Small for gestational age (weight)
Araujo - Sertaconazole (Topical), 2022
1
0.78
[
0.66
; 0.92]
-
16,222
not evaluable
Neonatal disorders
Persistent pulmonary hypertension
0
-
-
-
-
-
Long term consequences
Leukemia
Ross - Clotrimazole, 2003
1
0.94
[
0.39
; 2.25]
243
24
not evaluable
Intrauterine deaths
Early intrauterine death (< 22 weeks)
Molgaard-Nielsen - Clotrimazole/miconazole (Vaginal) (Controls unexposed, NOS), 2016 Daniel - Clotrimazole and/or miconazole (Vaginal), 2018
2
1.06
[
0.94
; 1.20]
7,184
6,069
not evaluable
Late intrauterine deaths (> 22 weeks)
Molgaard-Nielsen - Clotrimazole/miconazole (Vaginal) (Controls unexposed, NOS), 2016
1
1.43
[
0.89
; 2.30]
99
4,301
not evaluable
0.0
100.0
1.0