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The association between analgesic drug use in pregnancy and neurodevelopmental disorders: protocol for an umbrella review

机译：妊娠期镇痛药用药与神经发育障碍的关联：伞审查的议定书

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Maternal prenatal health has been shown to be an important influence on children’s developmental outcomes, which has led to an increased emphasis on providing more information to support clinical decisions in pregnancy. Several systematic reviews suggest that analgesic drug use during pregnancy may have neurodisruptive properties. However, no firm conclusions have yet been drawn on the associations between prenatal analgesic drug use and children’s long-term development of neurodevelopmental disorders such as autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD). Therefore, an umbrella review is proposed for the purpose of examining the associations between maternal analgesic drug use during pregnancy and diagnoses of neurodevelopmental disorders. Included systematic reviews will consist of studies examining the effect of maternal prenatal analgesic drug use, specifically ibuprofen, acetaminophen, aspirin, naproxen, diclofenac, and ketoprofen, on children’s neurodevelopmental disorder status. Examined drugs were restricted to those readily accessible and frequently used by pregnant women, and with characteristics that allow them to cross the placenta and directly affect fetal development. Outcomes will be restricted to formal clinical diagnoses of ASD and/or ADHD. Two reviewers will independently identify eligible reviews from six databases (e.g., PubMed, EMBASE, PsychINFO) from inception dates of databases to the date of data extraction, and conduct manual searches of reference lists, consultation with field experts, and scan of pre-print archives. Extracted data will also include short qualitative summaries by both reviewers. As part of quality assessment, a standardized measurement tool to assess systematic reviews (AMSTAR 2) will be used. A narrative synthesis is proposed to integrate findings from different, potentially methodologically heterogeneous, studies. This umbrella review of associations between maternal prenatal use of analgesic drugs and children’s neurodevelopmental disorders could allow for firmer conclusions to be drawn through the synthesis of all relevant published research. The synthesis of findings using high-quality evidence could provide more accurate healthcare information on the long-term effects of analgesic drugs on neurodevelopment, to better guide future clinical decisions during pregnancy. This review will also allow gaps and methodological differences in the literature to be identified, informing recommendations for future research. PROSPERO CRD42020179216 .
机译：母体产前健康已被证明对儿童发展成果的重要影响，这导致了加强重视提供更多信息，以支持怀孕的临床决策。若干系统评论表明，妊娠期间的镇痛药用途可能具有神经性破坏性质。然而，尚未结论尚未结论，但孕产病药物使用与儿童长期发展的神经发育障碍等疾病等症状的结论，如自闭症谱系障碍（ASD）或注意力缺陷多动障碍（ADHD）。因此，提出了一种伞形评论，用于检查妊娠期间母体镇痛药物之间的关联和神经发育障碍的诊断。包括系统评论将包括研究母体产前镇痛药物使用，特别是布洛芬，对乙酰氨基酚，阿司匹林，萘普生，双氯芬酸和酮洛芬对儿童的神经发育障碍状态的影响。检查药物仅限于孕妇容易获得和经常使用的药物，以及允许它们穿过胎盘并直接影响胎儿发育的特征。结果仅限于ASD和/或ADHD的正式临床诊断。两位审阅者将独立地识别从数据库的成立日期到数据提取日期的六个数据库（例如，PubMed，Embase，PsileInfo）的符合条件的评论，并进行手动搜索参考列表，与现场专家的咨询以及预先打印的扫描档案。提取的数据还将包括两个审阅者的短暂定性摘要。作为质量评估的一部分，将使用标准化测量工具来评估系统评论（AMSTAR 2）。提出了一种叙事合成，以从不同，潜在的方法上异质，研究中整合结果。这种母亲产前使用镇痛药物和儿童神经发育障碍之间的关联伞审查可以通过所有相关公布研究的合成来允许更坚定的结论。使用高质量证据的研究来综合可以提供更准确的医疗保健信息，了解镇痛药对神经发育的长期影响，以更好地指导怀孕期间的未来临床决策。本综述还将允许差距和方法论差异在要确定的文献中，告知未来研究的建议。 Prospero CRD420179216。

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