Metoclopramide And Pregnancy: Weighing The Risks And Benefits

Metoclopramide is a drug used to treat gastrointestinal issues, nausea, and vomiting caused by surgical operations, chemotherapy, or pregnancy. It is also used to help with lactation. While it is thought to be safe, there is limited information on the risk of specific malformations and fetal death. Some sources advise against its use during the first and third trimesters when possible.

Based on the studies reviewed, metoclopramide use during pregnancy was not associated with an increased risk of major congenital malformations overall, any of the 20 individual malformation categories assessed, spontaneous abortion, or stillbirth. However, there are case reports of people who developed severe side effects while taking metoclopramide during pregnancy, such as movement disorders and intermittent porphyria, which led to psychiatric conditions.

Metoclopramide is used to treat nausea and vomiting during pregnancy

Metoclopramide is a medication used to treat nausea and vomiting caused by various factors, including pregnancy. It is also used to treat gastrointestinal issues and to aid with lactation. While it is important to consult a healthcare provider before taking any medication during pregnancy, studies have shown that metoclopramide does not increase the risk of major congenital malformations or fetal death when used during pregnancy.

Metoclopramide is considered safe for use during pregnancy if the benefit outweighs the risk to the fetus. However, it is recommended to avoid using it during the first and third trimesters when possible. This is because there is a risk of extrapyramidal syndrome and methemoglobinemia in neonates exposed to the drug during these periods. Additionally, mothers are at a relatively high risk of postpartum depression after giving birth, and metoclopramide can cause depression as a side effect. Therefore, therapy with this drug should be avoided in women with a history of major depression and should not be used for prolonged periods during this vulnerable time.

Human data suggests that metoclopramide does not cause fetotoxicity or malformative toxicity. However, use of the drug towards the end of pregnancy may result in extrapyramidal syndrome in the neonate. Overall, metoclopramide is considered a safe and effective option for treating nausea and vomiting during pregnancy when other treatments are not effective.

It is important to note that metoclopramide can cross into breast milk, and the effects on the nursing infant are not fully understood. While most reports have not listed any side effects in nursing infants, the World Health Organization (WHO) recommends avoiding this drug during breastfeeding if possible due to the potential for neural development defects.

There is no evidence of an increased risk of major congenital malformations

Metoclopramide is a drug used to treat nausea and vomiting in pregnancy. It is considered safe to use during pregnancy, but there is limited information on the risk of specific malformations and fetal death.

Several studies have been conducted to investigate the safety of metoclopramide use during pregnancy, including its potential association with major congenital malformations. One study matched metoclopramide-exposed and unexposed women based on age, calendar year, and propensity scores. The study found no significant association between metoclopramide use and major congenital malformations overall or any of the 20 individual malformation categories assessed.

Another study, a retrospective cohort study involving members of Clalit Health Services in Israel, found that exposure to metoclopramide in the first trimester was not associated with a significantly increased risk of major congenital malformations. The rate of major congenital malformations was 5.3% in the exposed group and 4.9% in the unexposed group, with an adjusted odds ratio of 1.04.

A third study, a register-based cohort study in Denmark, found that among women exposed to metoclopramide in the first trimester, 25.3 per 1000 births had an infant with a major congenital malformation, compared to 26.6 per 1000 births in the unexposed group. The prevalence odds ratio for malformations overall was 0.93, indicating no significant association between metoclopramide use and malformations.

Overall, these studies suggest that there is no evidence of an increased risk of major congenital malformations associated with metoclopramide use during pregnancy. However, it is important to note that metoclopramide use during pregnancy should be carefully considered and weighed against the potential risks to the fetus.

There is no evidence of an increased risk of spontaneous abortion

Another study, which examined 1,222,503 pregnancies in Denmark over a 13-year period, found no significant association between metoclopramide use and spontaneous abortion. The study matched metoclopramide-exposed and unexposed women based on prescription fill rates and compared the risk of spontaneous abortion as a primary outcome.

In addition, a prospective multicenter international study investigated the effect of intrauterine exposure to metoclopramide on pregnancy outcomes. The study included 175 women who received metoclopramide and found no association between metoclopramide use and an increased risk of spontaneous abortions.

These findings suggest that metoclopramide use during pregnancy is not associated with an increased risk of spontaneous abortion. However, further research with larger sample sizes is needed to confirm these observations and provide more definitive conclusions.

There is no evidence of an increased risk of stillbirth

Metoclopramide is a drug used to treat gastrointestinal issues, nausea, and vomiting caused by surgical operations, chemotherapy, or pregnancy. It is also used to help with lactation. While it is a popular drug, there is some concern about its safety during pregnancy.

Several studies have been conducted to assess the safety of metoclopramide use during pregnancy, and the results indicate that the drug does not increase the risk of stillbirth. One study, conducted in Denmark between 1997 and 2011, matched metoclopramide-exposed and unexposed pregnant women based on age, calendar year, and propensity scores. The study found no significant association between metoclopramide use and an increased risk of stillbirth.

Another study, conducted in North Jutland County, Denmark, from 1991 to 1996, compared the outcomes of 309 women with singleton pregnancies who had prescriptions for metoclopramide with 13,327 women who did not receive any prescriptions during pregnancy. The study found no significant difference in the risk of stillbirth between the two groups.

Similarly, a large cohort study in Israel from 1998 to 2007, which included 113,612 singleton births, found that exposure to metoclopramide during the first trimester was not associated with a significantly increased risk of perinatal death.

These findings are consistent with other studies that have assessed the safety of metoclopramide during pregnancy. For example, a study in the United States that included over 1,200,000 pregnancies found no increased risk of stillbirth associated with metoclopramide use.

Overall, the available evidence suggests that metoclopramide use during pregnancy is not associated with an increased risk of stillbirth. However, it is important to note that metoclopramide should still be used during pregnancy only if clearly needed and when the benefits outweigh the risks to the fetus.

It is recommended that use during the first and third trimesters is avoided

Metoclopramide is a medication used to treat gastrointestinal issues, nausea, and vomiting caused by surgical operations, chemotherapy, or pregnancy. It is also used to help with lactation.

While human data does not indicate fetotoxicity or malformative toxicity associated with metoclopramide therapy, it is still recommended that use during the first and third trimesters is avoided when possible. This is because there is a risk of extrapyramidal syndrome and methemoglobinemia for neonates exposed during the third trimester and/or delivery. Additionally, mothers are at a relatively high risk for postpartum depression, and this drug can cause depression as a side effect. Therefore, therapy should probably be avoided in women with a history of major depression and not used for prolonged periods for any mother during this time of high susceptibility.

There is also limited information on the use of metoclopramide during breastfeeding. It is known that it can cross into breast milk, but the effects on the nursing infant are unknown. The World Health Organization (WHO) recommends that this drug should be avoided if possible due to the potential for neural development defects.

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