Women with chronic autoimmune diseases usually rely on powerful immunosuppressive drugs to keep symptoms in check. Such medications are often new to the market so have little or no track record of side effects on the women who take them or on the babies these women carry when pregnant. A recently published paper from medical researchers at Vanderbilt University in Nashville, Tennessee, indicates there is no significant risk associated with some of the most commonly prescribed immunosuppressants and adverse outcomes on fetal development.
Dr. William Cooper, MD, MPH, says his research team’s study is one of the first to compare autoimmune medications to pregnancy. Cooper holds two professorships - professor of health policy at Monroe Carell Jr. Children’s Hospital in Nashville and professor of pediatrics at the university. He says chronic autoimmune conditions affect as many as 4.5 million Americans, many of them women.
About half of all pregnancies are unplanned so the concern for fetal effects of a woman’s immunosuppressant medications is a very real concern. Women who don’t know or suspect they are pregnant will most likely continue taking these important medications as usual and ask questions only after the pregnancy is apparent. With so little study of the effects of these medications on pregnancy, there is a concern that this window of unawareness could be harmful.
The Cooper research team involved the study of 608 infants:
- 437 of whom were exposed to immunosuppressives during pregnancy
- 171 born to mothers taking these medications before but not during pregnancy
Women in the study were undergoing treatment for autoimmune conditions that included ankylosing spondylitis, inflammatory bowel disease, lupus, psoriatic and rheumatoid arthritis, and scleroderma.
Medical records indicate that, during their pregnancies, 437 of these women filled prescriptions for hydroxychloroquine, tumor necrosis factor (TNF), azathioprine, sulfasalazine, and other immune-suppressing drugs.
The birth outcomes of these women were compared to those of the women diagnosed with the same list of medical conditions but who took immune-suppressing medications before but not during pregnancy. The Vanderbilt study indicates no significant risks to the pregnancies or to the babies born of them, according to the study.
Future studies of larger populations will produce more conclusive results but, at this time, it seems a woman’s immunosuppressant drugs taken shortly before and during the first trimester are safe for the woman, the pregnancy, and the developing fetus.
Full details of the study were recently published in the online edition of the medical journal, Arthritis and Rheumatism.
Source: "Women taking immunosuppressive medications during pregnancy do not put their babies at risk." News Medical. 11 Nov 2013. Web. Retrieved 20 Nov 2013.