BACKGROUND Nausea and vomiting of pregnancy affects up to 80% of pregnant women, it typically occurs during the first trimester which is the most sensitive time for environmental exposures given organogenesis. Metoclopramide is an antiemetic drug used widely during NVP, but the findings of studies evaluating its safety of use in pregnancy is inconsistent. Therefore, we conducted a systematic review and meta-analysis to assess whether metoclopramide use during first trimester of pregnancy is associated with the risk of major congenital malformations. METHODS The systematic search using database included Pubmed, Embase, Web of science, and Cochrane library. Studies written in English, comprising with an exposed group and a control group, reporting major congenital malformation as an outcome were included. RESULTS Six studies assessing a total number of 33374 metoclopramide-exposed and 373498 controls infants were included in this meta-analysis. No significant increase in the rate of major congenital malformation was detected following metoclopramide use during first trimester (OR, 1.14; 95% CI, 0.93-1.38). CONCLUSIONS Metoclopramide use during first trimester of pregnancy was not associated with the risk of major congenital malformations.

中文翻译：

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在妊娠早期使用甲氧氯普胺和严重先天性畸形的风险：系统评价和荟萃分析。

背景妊娠恶心和呕吐影响多达 80% 的孕妇，它通常发生在孕早期，鉴于器官发生，这是对环境暴露最敏感的时期。甲氧氯普胺是一种在 NVP 期间广泛使用的止吐药，但评估其在妊娠期使用安全性的研究结果并不一致。因此，我们进行了系统评价和荟萃分析，以评估在妊娠头三个月使用甲氧氯普胺是否与严重先天性畸形的风险相关。方法系统检索使用的数据库包括Pubmed、Embase、Web of science 和Cochrane 图书馆。包括一个暴露组和一个对照组，报告主要先天性畸形作为结果的英文研究。结果 六项研究评估了总共 33374 名暴露于甲氧氯普胺的婴儿和 373498 名对照婴儿被纳入该荟萃分析。在妊娠早期使用甲氧氯普胺后，未检测到严重先天性畸形的发生率显着增加（OR，1.14；95% CI，0.93-1.38）。结论 妊娠头三​​个月使用甲氧氯普胺与严重先天性畸形的风险无关。