Women with chronic autoimmune diseases who take immunosuppressive medications during their first trimester of pregnancy are not putting their babies at significantly increased risk of adverse outcomes, according to a Vanderbilt study released online by the journal Arthritis and Rheumatism.
The paper is one of the first to describe risks for medications used to treat autoimmune diseases when taken during pregnancy, according to first author William Cooper, M.D., MPH, Cornelius Vanderbilt Professor of Pediatrics and professor of Health Policy at Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, Tenn.
"This study is important because these conditions affect nearly 4.5 million persons in the U.S., including many women of childbearing age," Cooper said. "Currently, there are almost no data to guide women who are pregnant, or planning to become pregnant, who may need to continue their medications during pregnancy."
Study authors used health plan data from Tennessee Medicaid, Kaiser Permanente Northern California and Southern California, linked with vital records and medical records. The three geographically diverse health plans collectively provide coverage for more than 8 million persons each year.
The cohort included 608 infants, including 437 with exposure during pregnancy and 171 whose mothers filled prescriptions for immunosuppressives before, but not during, pregnancy.
Women with rheumatoid and psoriatic arthritis, ankylosing spondylitis, lupus, scleroderma, and inflammatory bowel disease who filled prescriptions for immunosuppressive treatments during pregnancy were included in the study.
The drugs studied included hydroxychloroquine, tumor necrosis factor (TNF) inhibitors and other immunosuppressives such as sulfasalazine and azathioprine.
When compared with the women who had medication treatment before, but not during, pregnancy the risk ratios for adverse fetal outcomes as
|Contact: Craig Boerner|
Vanderbilt University Medical Center