Intest Res.  2016 Apr;14(2):139-145. 10.5217/ir.2016.14.2.139.

Pregnancy outcome in women with inflammatory bowel disease treated with anti-tumor necrosis factor and/or thiopurine therapy: a multicenter study from Japan

Affiliations
  • 1Department of Internal Medicine, National Defense Medical College, Saitama, Japan. ryota@ndmc.ac.jp
  • 2IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan.
  • 3Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan.
  • 4Department of Gastroenterology and Hepatology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
  • 5IBD Center, Yokohama City University Medical Center, Yokohama, Japan.
  • 6Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
  • 7Department of Internal Medicine, Division of IBD, Tokyo Yamate Medical Center, Tokyo, Japan.
  • 8Department of gastroenterology, Kanazawa University Hospital, Ishikawa, Japan.
  • 9Department of Gastroenterology and Hepatology, Keio University School of Medicine, Tokyo, Japan.
  • 10Division of Internal Medicine, Department of IBD, Hyogo College of Medicine, Hyogo, Japan.
  • 11Center for Advanced IBD Research and Treatment, Kitasato Institute Hospital, Tokyo, Japan.
  • 12Department of Internal medicine, Sakura Medical Center, Toho University, Sakura, Japan.
  • 13Department of Internal Medicine, National Defense Medical College, Saitama, Japan.

Abstract

BACKGROUND/AIMS
Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines.
METHODS
This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines.
RESULTS
Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037).
CONCLUSIONS
Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.

Keyword

Inflammatory bowel diseases; Anti tumor necrosis factor-alpha; Thiopurines; Pregnancy outcome

MeSH Terms

Adalimumab
Abortion, Spontaneous
Asia
Asian Continental Ancestry Group
Congenital Abnormalities
Cross-Sectional Studies
Female
Humans
Incidence
Infliximab
Infant, Low Birth Weight
Infant, Newborn
Inflammatory Bowel Diseases*
Japan*
Live Birth
Necrosis*
Pregnancy
Pregnancy Outcome*
Pregnancy*

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