title: Immunosuppressive drugs and fetal outcome.
abstract: Successful pregnancies have been reported in all types of solid-organ transplant recipients on a variety of immunosuppressive regimens. Immunosuppression is essential to maintain the transplanted organ and maternal health, thus the safety of these medications continues to be studied. This article reviews information in the literature and data from the National Transplantation Pregnancy Registry (NTPR) in the United States related to immunosuppressive medication and pregnancy. Although most maintenance immunosuppressive regimens have not been shown to affect the outcome of posttransplant pregnancies, mycophenolic acid products are associated with an increased incidence of spontaneous abortion and an increase in the incidence and a specific pattern of birth defects. When counseling transplant recipients about the prospect and safety of pregnancy, the health of the mother, her graft, and the developing fetus must all be taken into account.
authors.affiliation: National Transplantation Pregnancy Registry (NTPR), Gift of Life Institute, 401 N. 3rd Street, Philadelphia, PA 19123, USA. Electronic address: lcoscia@giftoflifeinstitute.org.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Coscia
authors.affiliation: Temple University School of Medicine, Kresge West, 3440 N. Broad St., Suite 100, Philadelphia, PA 19140, USA. Electronic address: Serban.Constantinescu@tuhs.temple.edu.
authors.forename: Serban
authors.initials: S
authors.lastname: Constantinescu
authors.affiliation: Institute of Cellular Medicine, 3rd Floor, Leech Building, Faculty of Medical Sciences, Framlington Place, Newcastle upon Tyne NE2 4HH, UK. Electronic address: J.M.Davison@newcastle.ac.uk.
authors.forename: John M
authors.initials: JM
authors.lastname: Davison
authors.affiliation: Lehigh Valley Hospital, 1250 S. Cedar Crest Blvd. Suite 210, Allentown, PA 18103, USA; University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Moritz
authors.affiliation: National Transplantation Pregnancy Registry (NTPR), Gift of Life Institute, 401 N. 3rd Street, Philadelphia, PA 19123, USA; University of Central Florida, Orlando, FL, USA. Electronic address: varmenti@giftoflifeinstitute.org.
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Armenti
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D009173:Mycophenolic Acid / Q000009:adverse effects*; D016377:Organ Transplantation; D011247:Pregnancy; D012307:Risk Factors; D064793:Teratogenesis / Q000187:drug effects; D014481:United States / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: fetus; immunosuppression; pregnancy; transplantation