Intestinal Research  2016;14(2):139-145

doi: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.

Shunsuke KOMOTO 1 ; Satoshi MOTOYA ; Yuji NISHIWAKI ; Toshiyuki MATSUI ; Reiko KUNISAKI ; Katsuyoshi MATSUOKA ; Naoki YOSHIMURA ; Takashi KAGAYA ; Makoto NAGANUMA ; Nobuyuki HIDA ; Mamoru WATANABE ; Toshifumi HIBI ; Yasuo SUZUKI ; Soichiro MIURA ; Ryota HOKARI

Affiliations

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Keywords

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

Country

Republic of Korea

Language

English

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.