Immunosuppressive Drugs and Pregnancy

Esplin, M. Sean; Branch, D. Ware

doi:10.1016/s0889-8545(05)70325-9

Cited by 21 publications

(8 citation statements)

References 71 publications

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“…Clinical experience and several clinical trials have shown minimal effects on the fetus with the administration of systemic GCS in the first trimester (40). Only small amounts of prednisone reach the fetus of a pregnant patient in an active form because a placental enzyme, 11‐hydroxysteroid dehydrogenase type 2, inactivates most prednisolone crossing into the fetal circulation.…”

Section: Major Side Effectsmentioning

confidence: 99%

Update on the dermatologic use of systemic glucocorticosteroids

Jackson¹,

Gilchrist²,

Nesbitt³

2007

Dermatol Ther

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Systemic glucocorticosteroids (GCS) remain a first-line therapy for a variety of dermatologic diseases. The purpose of this article is to review the major pharmacologic properties and drug interactions of GCS, as well as the mechanisms of action, dosing and delivery options, and major adverse effects. In addition, the present authors will discuss the major indications and practical suggestions for the use of systemic GCS in dermatology.

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Section: Major Side Effectsmentioning

confidence: 99%

Update on the dermatologic use of systemic glucocorticosteroids

Jackson¹,

Gilchrist²,

Nesbitt³

2007

Dermatol Ther

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“…The first successful pregnancy in a renal transplant patient occurred in 1958, and in 1991 the number of pregnancies in renal transplant patients was estimated at 2,309 [2]. By 1997, an estimated 5,000 pregnancies had occurred in transplant patients [3]. The European Transplant and Dialysis Association reported that the success rate of normal pregnancy reached 92%-95% in renal transplanted women with stable and well-preserved graft function, without hypertension and other risk factors (genetic defects) [4].…”

Section: Introductionmentioning

confidence: 99%

In utero exposure to immunosuppressive drugs: experimental and clinical studies

Tendron¹,

Jb²,

Decramer³

2002

Pediatric Nephrology

101

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Over the last few decades, the number of pregnant women under immunosuppressive (IS) therapy following transplantation or autoimmune diseases has increased. At first, IS drugs, including prednisone, azathioprine, and cyclosporine A were used, but now new molecules such as tacrolimus and mycophenolate mofetil have appeared. These IS drugs cross the placental barrier and enter into the fetal circulation, which poses a risk for fetal development. Experimental data have shown that IS drugs often have deleterious effects on fetuses, while human data have reported an increased rate of abortion, prematurity, intrauterine growth retardation (IUGR), and low birth weight, without significant increases in malformation rates. However, only limited information is available about the newly used molecules. Although fetal and neonatal data are reassuring, long-term effects of IS drugs on fertility, immune response and renal function, as well as the consequences of prematurity and IUGR, should be monitored.

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“…Large doses near the time of delivery may produce fetal hypothalamic-pituitary axis suppression, which is not usually clinically significant. 2,38,39 Prednisone has less effect than other CSs on the fetus because only minimal amounts reach the fetus in an active form as the placenta is rich in an enzyme (11b-hydroxysteroid dehydrogenase) that inactivates prednisolone. Fluorinated CSs, such as dexamethasone and betamethasone, are minimally altered by this enzyme, so higher concentrations reach the fetus.…”

Section: Resultsmentioning

confidence: 99%

Side Effects of Short-Term Oral Corticosteroids

Richards

2008

J Cutan Med Surg

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Problems are infrequent, but patients must be informed of all material risks and treatment options. Thorough chart documentation is required, and patient consent must be given. CS doses should be as low as possible, and CS courses should be as infrequent and as short as possible. The literature reviewed in this article clearly indicates that a short course of CS of 1 week, in the absence of specific contraindications, is unlikely to be harmful (psychotic or prepsychotic episodes possibly excepted).

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Immunosuppressive Drugs and Pregnancy

Cited by 21 publications

References 71 publications

Update on the dermatologic use of systemic glucocorticosteroids

Update on the dermatologic use of systemic glucocorticosteroids

In utero exposure to immunosuppressive drugs: experimental and clinical studies

Side Effects of Short-Term Oral Corticosteroids

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