Objective: The objective of this review is to gather the available evidence on the different drugs used in immune-mediated inflammatory diseases in pregnancy, lactation, their influence on female and male fertility, advice on discontinuation before conception and to help in routine clinical practice for better patient advice on family planning.
Methods: A bibliographic search was carried out, where published articles (review studies, observational studies and case series) in English or Spanish until April 2020 that analyzed the management of pregnancy, lactation and/or fertility in patients on treatment in immune-mediated diseases were selected.
Results: A total of 95 references were selected and the information on each drug was synthesized in tables. Drugs contraindicated in pregnancy are topical retinoids, pimecrolimus, cyclooxygenase 2 inhibitors, methotrexate, mycophenolate mofetil, leflunomide, acitretin, and thiopurines. The lack of data advises against the use of apremilast, tofacitinib, baricitinib, anakinra, abatacept, tocilizumab and the new biologicals. Topical salicylates, paracetamol, ultraviolet therapy and hydroxychloroquine treatment are safe, and anti-TNF biological therapy are considered low risk, with certolizumab being the drug of choice throughout pregnancy and lactation. Most are compatible with paternal exposure except for sulfasalazine, mycophenolate and leflunomide, for which suspension of treatment prior to conception is recommended, and cyclosporine with dose requirements of less than 2 mg/kg/day.
Conclusions: In this context of chronic treatments with teratogenic potential, it is necessary to highlight the importance of pregnancy planning to select the safest drug. Given the quality of the available data, it is still necessary to continuously update the information, as well as to promote observational studies of cohorts of pregnant patients and men of childbearing age, including prospective studies, in order to generate more scientific evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.farma.2022.12.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Investigating the association between labor pain and cessation of breastfeeding.
Sci Rep
December 2024
Department of Women's Anesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Mothers encounter several challenges to sustain breastfeeding until the recommended 6 months of age. There is limited evidence on the impact of women's labor pain experiences upon cessation of breastfeeding. We aimed to investigate the association between women's labor pain experiences, intrapartum interventions, and pre-birth psychological vulnerabilities and cessation of breastfeeding.
View Article and Find Full Text PDFDecadal trends in the exclusive breastfeeding practices among working Indian mothers: a multi-level analysis.
Int Breastfeed J
December 2024
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda (Punjab), Bathinda, 151001, India.
Background: Exclusive breastfeeding (EBF) is defined as feeding infants only breast milk of the mother or a wet nurse for the first six months, without additional food or liquids except the oral rehydration solution or drops/syrups of vitamins, minerals or medicines. The working status of women in developed countries adversely affects the EBF rates, which calls for an assessment in rapidly developing countries like India. Therefore, the primary aim of the present study is to determine the prevalence of EBF using the data from the National Family Health Surveys (NFHS 3, 4, 5) conducted between 2005 and 06, 2015-16 and 2019-21 to estimate the likelihood EBF according to mothers' employment status.
View Article and Find Full Text PDFMobile-based peer-led theoretically-designed intervention on continued breastfeeding among Iranian mothers.
BMC Pregnancy Childbirth
December 2024
Department of Public Health, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, P.O. Box, Tehran, 19835-35511, Iran.
Background: This study addresses the determination of educational intervention-based on the Theory of Planned Behavior (TPB)-effectiveness on continued breastfeeding among Iranian mothers attending health centers, considering low researchers' attention to the continued breastfeeding index despite its important impact on children's health.
Methods: The present study was conducted among 230 mothers with exclusively breastfed infant (115 in the intervention group and 115 in the control group). Sampling starts with randomly selecting 12 health centers among all health centers in Karaj, Alborz province, and allocating them randomly into two equal groups of intervention and control.
Pregnancy-induced mechanisms regulating central and peripheral leptin sensitivity: lessons from sheep.
Domest Anim Endocrinol
December 2024
Department of Animal Biotechnology, Faculty of Animal Sciences, University of Agriculture in Krakow, Mickiewicza 21 31-120, Krakow, Poland. Electronic address:
This review describes various aspects of the leptin resistance phenomenon and related physiological mechanisms that occur in pregnant sheep. Its main aim is to analyze the mechanisms that determine the occurrence of pregnancy-induced leptin resistance and to investigate the accompanying processes that affect the physiology of pregnancy and lactation in livestock. The main purpose of this analysis was to comprehensively understand the phenomenon of leptin resistance, including the causes of its emergence and its effects on nonrodent organisms.
View Article and Find Full Text PDFHIV Pre-exposure Prophylaxis (PrEP) during Pregnancy and Lactation.
MCN Am J Matern Child Nurs
October 2024
Jillian Pintye is an Associate Professor at the University of Washington School of Nursing, Seattle, WA. Dr. Pintye can be reached at
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!