Abstract
Background: Interferon (IFN) is widely applied in viral hepatitis and multiple oncologic diseases. Whereas, there is considerable controversy on how to deal with unintended pregnancy during IFN treatment. Methods: Following the guidelines of PRISMA, a systematic review was performed to retrieve all published articles involving IFN exposure during pregnancy. Electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, and major Chinese database were searched for possibly relevant articles published up to March 2020. Findings: From 9819 original references, 17 studies involving 3543 pregnancies were eligible for meta-analysis. Only 8 cases report were retrieved relevant with IFN-α exposure in pregnant women with viral hepatitis, and none presented birth defects. The meta-analysis evaluating safety of IFN-α showed risks of pregnancy outcomes, including birth defects were not higher than the control population. Further comprehensive meta-analysis concerning with IFN-α and IFN-β demonstrate the risks of live birth (OR 0.89, 95% CI: 0.62-1.27), spontaneous abortion (OR 1.09, 95% CI: 0.73-1.63), stillbirth (OR 1.38, 95% CI: 0.51-3.72), preterm delivery (OR 1.24, 95% CI: 0.85-1.81), and maternal complications (OR 0.72, 95% CI: 0.38-1.38) were comparable with the unexposed group. Additionally, the pooled estimates of live birth, spontaneous abortion, still birth, preterm deliveries, and maternal complications were 85.2%, 9.4%, 0%, 7.5%, and 6.5%, respectively. Importantly, the risk of birth defects was not increased (OR 0.68, 95% CI: 0.39-1.20) with pooled rate of 0.51 %. Interpretation: IFN exposure during pregnancy does not increase the risk of adverse outcomes. The rates of major pregnancy outcomes are comparable with general population and un-exposed population, which provides important information to both hepatologists and obstetricians regarding the risks of IFN exposure against potential risks of induced abortion. Funding: National Natural Science Foundation of China and Key R&D Program of Shaanxi. Declaration of Interests: All authors declare no competing interests.
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