Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study

  title={Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study},
  author={Jessica Coelho and Laurent Beaugerie and J F Colombel and Xavier H{\'e}buterne and {\'E}ric Lerebours and Marc L{\'e}mann and Philippe Baumer and Jacques Cosnes and Arnaud Bourreille and Jean Pierre Gendre and Philippe Seksik and Antoine Blain and Etienne Henry Metman and Andr{\'e}e Nisard and Guillaume Cadiot and Michel Veyrac and Benoit Coffin and Xavier Dray and Fabrice Carrat and Philippe Marteau},
  pages={198 - 203}
Background and aims Few studies have been conducted addressing the safety of thiopurine treatment in pregnant women with inflammatory bowel disease (IBD). The aim of this study was to evaluate the pregnancy outcome of women with IBD who have been exposed to thiopurines. Methods 215 pregnancies in 204 women were registered and documented in the CESAME cohort between May 2004 and October 2007. Physicians documented the following information from the women: last menstrual date, delivery term… 
Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs
A benefit–risk ratio should be considered in prescribing or continuing medicinal therapy during pregnancy of IBD patients and congenital abnormalities were increased significantly in thiopurine-exposed group in comparison with control group who did not receive any medicine for IBD treatment.
Intrauterine exposure and pharmacology of conventional thiopurine therapy in pregnant patients with inflammatory bowel disease
Pregnancy has a major effect on maternal thiopurine metabolism, which raises the question whether infants should be tested for possible anaemia immediately after birth, and in utero the unborn child is exposed to 6-TGN, but not to 7-MMP.
The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy
Data from a meta-analysis of all original human studies reporting outcomes in pregnancy in patients receiving thiopurines for IBD treatment in pregnancy provide support for thiopURines having a minimal risk, if any, to the fetus.
Safety of Tioguanine During Pregnancy in Inflammatory Bowel Disease.
This relatively small case series supports safe use of TG in pregnant IBD patients, and consideration should be given to the indication and continuation of TG during pregnancy.
Use of Thiopurines During Conception and Pregnancy Is Not Associated With Adverse Pregnancy Outcomes or Health of Infants at One Year in a Prospective Study
Maternal and fetal outcomes in pregnant Japanese women with inflammatory bowel disease: our experience with a series of 23 cases
Assessment of patients with IBD during pregnancy confirmed that even if the disease flares up during pregnancy, good pregnancy outcomes can be achieved with an optimal intensification of the patient's treatment.
Thiopurines during pregnancy in inflammatory bowel disease: is there a risk for the (unborn) child?
Conventional thiopurines, being azathioprine (AZA) and mercaptopurine (MP) are considered the cornerstone of immunosuppressive maintenance therapy in patients with inflammatory bowel disease (IBD)
CESAME Substudy on Thiopurines in Pregnancy: Is This the Baby We Were Waiting For?
The study by Coelho et al recently published in Gut aimed at evaluating pregnancy outcomes in female IBD patients treated with thiopurines, finding that there was no increase in the risks of congenital abnormalities.
Safety of Thiopurines and Anti-TNF-α Drugs During Pregnancy in Patients With Inflammatory Bowel Disease
The treatment with thiopurines and anti-TNF-α drugs does not seem to increase the risk of complications during pregnancy and does seem to be safe for the newborn.


The Effect on the Fetus of Medications Used to Treat Pregnant Inflammatory Bowel-Disease Patients
In 113 female patients with 207 conceptions none of the drugs used to treat IBD is associated with poor pregnancy outcomes and in multivariate analyses controlling for age of mother, there was no evidence that 5-ASA type drugs or any type of drug influenced pregnancy outcome.
The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: a retrospective cohort study.
6-MP use before or at conception or during pregnancy appears to be safe, and Discontinuation of the drug before and during pregnancy is not indicated.
[Pregnancy outcome in inflammatory bowel diseases].
Pregnancy outcome is approaching that observed in a normal population, except for an elevated rate of preterm births, and there is no need to stop maintenance therapy with 5-aminosalicylates or azathioprine during pregnancy.
Early pregnancy azathioprine use and pregnancy outcomes.
Infants exposed to AZA in early pregnancy may be at a moderately increased risk of congenital malformations, specifically ventricular/atrial septal defects, and there is also an increasedrisk of growth restriction and preterm delivery.
Complications of Pregnancy and Child Development After Cessation of Treatment With 6-Mercaptopurine for Inflammatory Bowel Disease
The incidence of fetal loss is higher in women with inflammatory bowel disease who had been previously treated with 6-MP compared with those who had not, and there was no increase in the incidence of developmental defects when the mothers had been treated with 7-MP prior to pregnancy.
Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California.
Women with IBD are more likely to have an adverse outcome related to pregnancy and disease activity and medical treatment did not predict adverse outcomes in a large, nonreferral population.
A meta-analysis on the influence of inflammatory bowel disease on pregnancy
The study has shown a higher incidence of adverse pregnancy outcomes in patients with IBD, who should be treated as a potentially high-risk group.