title: The use of biologic agents in pregnancy and breastfeeding.
abstract: Biologic therapies, including anti-tumor necrosis factor antibody therapy and anti-integrin antibodies, are currently approved for the treatment of and are increasingly being used in patients with moderate to severe inflammatory bowel disease, including Crohn disease and ulcerative colitis. Because patients who require these medications are often in their child-bearing years, knowledge of the safety of these medications before and after pregnancy is imperative. This article summarizes the available data regarding the use of biologic therapy during and after pregnancy, highlighting such issues as safety for mother and newborn, length of medication use during pregnancy, and breastfeeding after pregnancy while on biologic therapy.
authors.affiliation: Vanderbilt University Medical Center, 1211 21st Avenue, South 220 Medical Arts Building, Nashville, TN 37232, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Horst
authors.affiliation: Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: Kane.Sunanda@mayo.edu.
authors.forename: Sunanda
authors.initials: S
authors.lastname: Kane
mesh_terms: D000068879:Adalimumab; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D001942:Breast Feeding; D000068582:Certolizumab Pegol; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab; D016023:Integrins / Q000037:antagonists & inhibitors; D000069442:Natalizumab; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007140:Immunoglobulin Fab Fragments; D007166:Immunosuppressive Agents; D016023:Integrins; D000069442:Natalizumab; D014409:Tumor Necrosis Factor-alpha; D011092:Polyethylene Glycols; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068582:Certolizumab Pegol
keywords: Biologic; Breastfeeding; Crohn disease; Inflammatory bowel disease; Pregnancy; Ulcerative colitis