Review
Copyright ©2013 Baishideng Publishing Group Co.
World J Gastroenterol. May 7, 2013; 19(17): 2591-2602
Published online May 7, 2013. doi: 10.3748/wjg.v19.i17.2591
Table 1 Summary of reports of maternal exposure to anti-tumor necrosis factor agents during pregnancy
Ref.Study typeDiseaseAnti-TNF-αagentExposure to other drugsExposures in pregnancies with documented outcomeMaternal exposure: Pregnancy stageLive births (n)SA/SB (n)PTB/PMB (n)LBW/SGA (n)CA (n)Pregnancy outcomes: Details/complications
Chambers et al[18]ProspectiveRAIFXNS4T131 SA2
Mahadevan et al[19]ProspectiveCD: (4) UC: (1)IFXNS5T2/T3 other exposure details NS5
Berthelot et al[20]Case seriesRheumatologic diseaseIFX-13C/T1: 1 C/T1/T2: 23
Chakravarty et al[21]Case seriesRAIFXSome pts1Pregnancy, not otherwise specified1
Correia et al[22]Case seriesCDIFXYes: 12C/T1/T2/T3211 SGA1 preterm/premature birth due to placental detachment (31 wk, 1.6 kg with acute respiratory failure requiring mechanical ventilation × 24 h and intensive care × 40 d; healthy at 8 mo follow-up)
No: 1
Hyrich et al[23]Case seriesRheumatologic diseaseIFXSome pts3C/T121 SA
Kane et al[24]Case seriesCDIFXSome pts3T1/T2/T3: 2 T2/T3: 131
Katz et al[25]Case seriesCD: (82)IFXSome pts100C: 536810113CA (3):
UC: (1)T1: 30SALBW1 full-term with tetralogy of Fallot
RA: (8)> 3 mo1 intestinal malrotation
JRA: (2)prior to C: 711 developmental delay and hypothyroidism
Unknown:(3)Unknown: 6SB1 complicated neonatal course:
Respiratory distress/jaundice/seizure. Mother was also exposed to several antibiotics for pulmonary and urinary infections, azathioprine, hydrocortisone, and total parental nutrition early in pregnancy
Miscarriages (14):
10 SA
1 SB (mother exposed to leflunomide)
3 unknown type
Mahadevan et al[26]Case seriesCDIFXSome pts10T1: 110311 neonatal jaundice (resolved)
T3: 1LBW1 complicated neonatal course: term delivery at 39 wk with respiratory distress/desaturation/gastric ulcer day 5; healthy at 6 mo follow-up
C/T1/T2/T3: 8
Rosner et al[27]Case seriesRheumatologic diseaseIFXYes3C/T1/T2/T3311 premature rupture of membranes
Schnitzler et al[28]Case seriesCD/UC/ICIFXNS10C/T1/T2912
SB
Weber-Schoenderfer et al[29]Case seriesNSIFXNS25T122242CA (2):
SA1 ventricular septal defect
1 growing hemangioma requiring therapy
Zelinkova et al[30]Case seriesCD: (3)IFXSome pts4C/T1/T2: 3411CA (1):
UC: (1)C/T1/T2/T3: 1L hand polydactyly (Infant also had respiratory depression after anesthetics that resolved spontaneously. Mother was taking methotrexate 2 mo prior to conception without folic acid supplement.)
Akinci et al[31]Case reportRheumatologic diseaseIFXYes1C/T1/T2/T31
Angelucci et al[32]Case reportCDIFXYes1C/T1111
LBW
Angelucci et al[33]Case reportCDIFXYes1T11
Antoni et al[34]Case reportPsoriatic ArthritisIFXNS1C/T11
Arai et al[35]Case reportCDIFXYes1C/T1/T21
Aratari et al[36]Case reportCDIFXYes1T211
SGA
Burt et al[37]Case reportCDIFXYes1C/T111
Chaparro et al[38]Case reportCDIFXNS1C/T1/T2/T311
Cheent et al[39]Case reportCDIFXNS1C/T1/T2/T311Infant developed disseminated BCG after vaccination at 3 mo and died at 4.5 mo
Epping et al[40]Case reportCDIFXYes1C/T1/T2/T31
Hou et al[41]Case reportCDIFXNS1C/T1/T2/T31
James et al[42]Case reportCDIFXYes1T21
Kinder et al[43]Case reportRAIFXYes1C/T101
SA
Østensen et al[44]Case reportRAIFXYes1C/T11Oligohydramnios detected on 18 wk ultrasound that resolved with discontinuation of Nimesulide
Puig et al[45]Case reportPsoriasisIFXYes1C/T1/T2/T31
Srinivasan et al[46]Case reportCDIFXYes12C/T111Preterm premature birth (24 wk) complicated by intracerebral and intrapulmonary hemorrhages and neonate died at 3 d
Mother was also exposed to metronidazole, azathioprine, and mesalamine for fistulizing CD
Steenholdt et al[47]Case reportUCIFXYes1C/T1/T2/T31
Stengel et al[48]Case reportCDIFXYes1C/T1/T2/T31
Tursi et al[49]Case reportCDIFXNS1C/T1/T2/T311
Vasiliauskas et al[50]Case reportCDIFXNS1C/T1/T2/T31
Wilbaux et al[51]Case reportASIFXNS1C/T11
Xirouchakis et al[52]Case reportCDIFXYes1C/T111Preterm (29 wk) birth with neonatal hospitalization × 30 d post-delivery. Baby in “good condition” at follow-up
Johnson et al[53,54]ProspectiveCD and RAADANS94T18013127CA (7) ( live births):
Other exposure details NSSA(among live births)1 undescended testicle
1 microcephaly
1 congenital hip dysplasia with inguinal hernia
1 congenital hypothyroidism
1 ventricular septal defect
1 bicuspid aortic valve and agenesis of corpus callosum (twin sibling had patent ductus arteriosus)
1 congenital hydronephrosis
CA (9) (all pregnancies):
In addition to above 7 defects were:
1 spina bifida and hydrocephalus (resulted in elective termination)
1 ectopia cordis and caudal regression (twin pregnancy resulting in a spontaneous abortion)
Berthelot et al[20]Case seriesRheumatologic diseaseADA-32C/T1: 12
C/T1/T2/T3: 1
Hyrich et al[23]Case seriesRheumatologic diseaseADASome pts3C/T121 SA
Johnson et al[53,54]Case seriesCD and RAADANS122T112255 CA (5):
other exposure details NS2 chromosomal abnormalities
1 atrial septal defect and peripheral pulmonic stenosis
1 ventricular septal defect
1 congenital hip dysplasia
Weber-Schoenderfer et al[29]Case seriesNSADANS28T124241 infant with autosomal dominant disease (not otherwise specified); paternal inheritance
SA
Abdul Wahab et al[55]Case reportCDADAYes1C/T1/T2/T321Twin-to-twin transfusion syndrome
(twins)SGA(1 small due to discordance)
Ben-Horin et al[56]Case reportCDADANS1C/T1/T2/T31
Bosworth et al[57]Case reportCDADAYes1C/T1/T2/T311
Coburn et al[58]Case reportCDADAYes1T2/T31
Dessinioti et al[59]Case reportPsoriasisADANS1C/T111Infant reported as “normal” at 12 mo follow-up
LBW
Jurgens et al[60]Case reportCDADANS1C/T11
Kraemer et al[61]Case reportTakayasau’s ArteritisADAYes1C/T1/T2/T31
Mishkin et al[62]Case reportCDADAYes1C/T1/T2/T31
RAADANS1C/T111
Roux et al[63]Case report
Vesga et al[64]Case reportCDADAYes1C/T1/T2/T31
Wibaux et al[51]Case reportASADAYes1C/T1/T211CA (1):
Primary craniosynostosis requiring surgery
Kane et al[65]Case seriesCDCTZNS14NS511
SASGA
Mahadevan et al[66]Case reportCDCTZYes1T2/T31
Ousallah et al[67]Case reportCDCTZNS1C/T1/T31
Steinberg et al[68]Case reportCDCTZYes1T21