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Meta-Analysis
. 2021 Apr;9(2):e00745.
doi: 10.1002/prp2.745.

Side-effects of carbetocin to prevent postpartum hemorrhage: A systematic review and meta-analysis of randomized controlled trials

Wen Ai  1 , Yanfei Zeng  1 , Yubo Ma  2 , Li Liu  3 , Dazhi Fan  4 , Song Wu  5 , Yinghui Zhang  1
Affiliations
Meta-Analysis

Side-effects of carbetocin to prevent postpartum hemorrhage: A systematic review and meta-analysis of randomized controlled trials

Wen Ai et al. Pharmacol Res Perspect. 2021 Apr.

Abstract

Postpartum hemorrhage (PPH) increases the risk of maternal death worldwide. Heat-stable carbetocin, a long-acting oxytocin analog, is a newer uterotonic agent. Clinicians do not fully understand its side-effects, particularly the unanticipated side-effects. The aim of this study is to investigate the side-effects of carbetocin to PPH. The Cochrane Library, Web of Science, PubMed, Elsevier ScienceDirect, Embase, and ClinicalTrials.gov were searched from the inception to September 2020. Randomized controlled trials (RCTs) that considered pregnant women who received carbetocin before delivery and provided at least one adverse event were included. Statistical analysis included random or fixed-effect meta-analyses using relative risk. Stratified analyses and sensitivity analyses were also performed. Begger's and Egger's test and funnel plots were used to assess the publication bias. Seventeen RCTs involving 32,702 women were included, and all these studies ranked as medium- to high-quality. Twenty-four side-effects were reported. The use of carbetocin had a lower risk of vomiting in intravenously (0.53, 0.30 to 0.93) and cesarean birth (0.51, 0.32 to 0.81) women, and had a slightly higher risk of diarrhea (8.00, 1.02 to 62.79) compared with oxytocin intervention. No significant difference was found among other side-effects. Evidence from our systematic review and meta-analysis of 17 RCTs suggested that the risk of vomiting decreased with carbetocin use in the prevention of PPH after delivery.

Keywords: carbetocin; meta-analysis; postpartum hemorrhage; side-effects; systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Flow chart of systematic review and meta‐analysis
FIGURE 2
FIGURE 2
Proportions of articles that met each criterion for risk of bias across the 17 included randomized controlled trials
FIGURE 3
FIGURE 3
Results of the risk of bias for 17 included randomized controlled trials. Green means low risk; yellow means unclear risk; red means high risk
FIGURE 4
FIGURE 4
Results of side‐effects in this meta‐analysis
See this image and copyright information in PMC

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