In utero Exposure to Immunosuppressive Drugs

Prévot, Anne; Martini, Stephan; Guignard, Jean‐Pierre

doi:10.1159/000047187

Cited by 49 publications

(29 citation statements)

References 39 publications

(103 reference statements)

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“…It was first used in clinical trials 13 years ago at our center, and many other centers have confirmed our initial findings of safety and efficacy of the drug in clinical LTx (12). Its safety in pregnancy has been similarly described by us (5) and others (13)(14)(15)(16). It is important to note that this is a case series with only 39 mothers and 49 babies, and that it is premature to draw a firm conclusion.…”

Section: Fludrocortisonesupporting

confidence: 67%

Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years1

Jain¹,

et al. 2003

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Section: Fludrocortisonesupporting

confidence: 67%

Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years1

Jain¹,

et al. 2003

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“…Additionally, fetal and neonatal adverse effects in brain, kidney, lung skeleton, gastrointestinal tract and cardiovascular system have also been reported after the use of NSAIDs during prenatal (Antonucci et al, 2012;Boubred et al, 2006). Other drugs used by pregnant women during prenatal, like immunosuppressive drugs, are not associated with higher risk of congenital anomalies but can be associated with an increased incidence of prematurity, intrauterine growth retardation and low birth weight (Prévot et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of medication use among low risk pregnant women: A drug utilization study

Fontoura¹,

Ayres²,

Martins-Nagai³

et al. 2014

Afr. J. Pharm. Pharmacol.

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This study aimed to characterize the profile of medication consumption by low risk pregnant women and to correlate it with sociodemographic characteristics of this population. A cross-sectional descriptive study was conducted in the Reference Center of Women's Health in the Brazilian municipality of Ribeirão Preto. This study included women which were at least in the 32nd week of the gestation period. Data related to sociodemographic characteristics of the pregnant women and to their pregnancy and medication consumption were collected from June, 2008 to November, 2008. A total of 699 pregnant women were included. About 20% of the pregnant women began prenatal care in the 12th week of gestation and 75.3% had at least six antenatal visits. The use of at least one drug during pregnancy was reported by 98% of the participants. The mean number of medications used was 4.35. According to the Food and Drug Administration (FDA) risk classification, 14.07% of the medication belonged to C category, 1.85% to D and 0.03% to X, and 38.30% were not identified or not classified by the FDA. When correlating the number of prenatal visits with the amount of medication used, it was verified that pregnant women who underwent less than six visits during pregnancy used a higher number of medications. Pregnant women have been exposed to a variety of medications and there is a need to improve the quality of care in order to prevent potential risks to the fetus, especially in relation to the use of medications.

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“…Azathioprine concentration in the placenta is relatively high, reaching 64-93% of the concentration in the maternal serum. However, the concentration in fetal blood is much lower, and is 1-5% of that in the maternal serum [14][15][16]. Cyclosporine A cross the placenta, reaching about 5% fetal blood concentration compared to the concentration in the maternal serum [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…However, the concentration in fetal blood is much lower, and is 1-5% of that in the maternal serum [14][15][16]. Cyclosporine A cross the placenta, reaching about 5% fetal blood concentration compared to the concentration in the maternal serum [14][15][16][17][18]. Systematic literature review published in 2016 by the European League Against Rheumatism shows compatibility with pregnancy and lactation for azathioprine, cyclosporine, tacrolimus and glucocorticosteroids [19].…”

Section: Discussionmentioning

confidence: 99%

Intrauterine growth restriction in pregnant women after kidney transplantation as a marker of preeclampsia

et al. 2016

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Objectives: Delayed motherhood is associated with an increasing number of comorbidities such as glomerulonephritis, systemic lupus erythematosus, and diabetic nephropathy. Women after renal transplant belong to the group of patients who require a highly individualized approach to treatment and diagnosis. The aim of the study was to validate the commonly used diagnostic criteria for preeclampsia which seem to be irrelevant in patients with chronic renal insufficiency. Material and methods:The course of pregnancy and delivery were retrospectively analyzed in 48 renal transplant patients. Two patients were excluded. Group I included 23 patients with eutrophic neonates, while Group II consisted of 23 patients with fetal hypotrophy (birth weight of < 10 th percentile). Results:The duration of pregnancy was 34.5 and 35 weeks in Groups I and II, respectively. Mean birth weight in Groups I and II was 2608.64 g and 2046.30 g, respectively (p = 0.002). Mean weight percentile in Groups I and II was 36.57 and 2.91, respectively (p < 0.000). Proteinuria in the first half of pregnancy occurred in 16 and 14 patients from Groups I and II, respectively, and increased in the second half of pregnancy in 6 and 6 patients from Groups I and II, respectively. Patients from Group II were more prone to urinary tract infections (0.43 vs. 0.79; p = 0.02). Conclusions:Current diagnostic criteria for preeclampsia are insufficient in case of pregnant women after kidney transplant. General criteria should be applied with special care in women with chronic kidney disease or in patients with systemic lupus erythematosus. As a predictive factor of neonatal morbidity, intrauterine growth restriction seems to be more valuable than typical markers of kidney function.

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In utero Exposure to Immunosuppressive Drugs

Cited by 49 publications

References 39 publications

Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years1

Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years1

Prevalence of medication use among low risk pregnant women: A drug utilization study

Intrauterine growth restriction in pregnant women after kidney transplantation as a marker of preeclampsia

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