Intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn's disease.
OBJECTIVE
To study the effects of infliximab on pregnancy and foetal outcome.


METHODS
We conducted a retrospective chart review of women with Crohn's disease treated intentionally with infliximab during pregnancy. The primary outcome measure was the occurrence of congenital malformations. Secondary outcome measures were the rate of premature birth, low-birth weight, small for gestational age infants, intrauterine growth retardation and caesarean section.


RESULTS
Ten women were identified. Eight women received maintenance infliximab infusions throughout their pregnancy and two women received their initial infliximab infusions during pregnancy. All 10 pregnancies ended in live births. No infants had congenital malformations, intrauterine growth retardation or small for gestational age parameters. Three infants were premature and one had low-birth weight. Eight women had a caesarean section.


CONCLUSIONS
This is the first reported series of intentional infliximab use throughout pregnancy. These data, combined with other studies of inadvertent use of infliximab during pregnancy, suggest that the benefits of infliximab in achieving response and maintaining remission in mothers with Crohn's disease may outweigh the risk to the foetus of exposure to the drug. Further prospective data collection will be helpful to confirm these findings.
Mahadevan
U
U
Division of Gastroenterology, Department of Medicine, University of California San Francisco, CA 94115, USA. umamah@itsa.ucsf.edu
Kane
S
S
Sandborn
W J
WJ
Cohen
R D
RD
Hanson
K
K
Terdiman
J P
JP
Binion
D G
DG
D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D000069285:Infliximab; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab