Outcome of Pregnancies in Female Patients With Inflammatory Bowel Diseases Treated With Vedolizumab

Autor: Elisabeth Macken, Wouter Van Moerkercke, Evelien Humblet, Sophie Dewit, Beatrijs Strubbe, Marc Ferrante, Karen van Hoeve, Jean-François Rahier, Annick Moens, Denis Franchimont, Annelies Posen, Peter Bossuyt, Jochen Nijs, Severine Vermeire, Anneleen Van Hootegem
Přispěvatelé: Belgian IBD Research and Development group (BIRD)
Rok vydání: 2018
Předmět:
Adult
medicine.medical_specialty
Gestational Age
Antibodies
Monoclonal
Humanized
Severity of Illness Index
Vedolizumab
Miscarriage
Congenital Abnormalities
03 medical and health sciences
Young Adult
0302 clinical medicine
Belgium
Gastrointestinal Agents
Pregnancy
Severity of illness
Medicine
Birth Weight
Humans
Retrospective Studies
Fetal Growth Retardation
business.industry
Obstetrics
Gastroenterology
Infant
Newborn
Pregnancy Outcome
Gestational age
General Medicine
Stillbirth
medicine.disease
Inflammatory Bowel Diseases
Abortion
Spontaneous
Pregnancy Complications
030220 oncology & carcinogenesis
Infant
Small for Gestational Age
Apgar Score
Small for gestational age
Premature Birth
030211 gastroenterology & hepatology
Apgar score
Female
Human medicine
business
Premature rupture of membranes
Live Birth
medicine.drug
Zdroj: Journal of Crohn's and colitis
ISSN: 1876-4479
1873-9946
Popis: Background and Aims: Vedolizumab is an IgG1 anti-alpha 4 beta 7 integrin antibody approved for the treatment of inflammatory bowel diseases[IBD], but without clear safety data during conception, pregnancy and nursing. Animal studies showed that mucosal vascular addressin cell adhesion molecule 1[MAdCAM-1] is expressed by maternal vessels in the placenta and recruits alpha 4 beta 7-expressing cells that are considered important for maternal/fetal tolerance. Blocking this interaction by vedolizumab might affect this process. We aimed to evaluate pregnancy outcomes in vedolizumab-treated female IBD patients. Methods: We conducted a retrospective, multicentre Belgian observational study. Details on disease activity, prenatal complications, delivery and neonatal outcome were collected through a case report form. Results: Twenty-four pregnancies were reported. Five women had active disease at conception and one patient flared during pregnancy. There were 23 live births. Complications were observed in 25% of pregnancies[premature rupture of membranes, pre-eclampsia, miscarriage, elective termination and stillbirth] and in 35% of infants[prematurity, intra-uterine growth retardation, small for gestational age and congenital malformations including hip dysplasia, pulmonary valve stenosis and Hirschprung's disease]. Vedolizumab was continued throughout pregnancy in two females and stopped in the 1st and 2nd trimester in five and 16 patients, respectively. For live born children, the median [interquartile range] gestational age, weight and Apgar score 5 min after birth were 39 [37-39.6] weeks, 3270 [3080-3585] grams and 10 [9-10], respectively. Conclusions: Although several complications were observed, both in mothers and in newborns, no firm conclusions can be drawn. Awaiting prospective and controlled registries, vigilance and strict follow-up of pregnant patients treated with vedolizumab seems mandatory.
Databáze: OpenAIRE
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