title: Pregnancy outcome in women with inflammatory bowel disease treated with anti-tumor necrosis factor and/or thiopurine therapy: a multicenter study from Japan.
abstract: OBJECTIVE
  Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines.
  
  
  METHODS
  This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines.
  
  
  RESULTS
  Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037).
  
  
  CONCLUSIONS
  Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.
authors.affiliation: Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Komoto
authors.affiliation: IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Motoya
authors.affiliation: Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishiwaki
authors.affiliation: Department of Gastroenterology and Hepatology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.affiliation: IBD Center, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Kunisaki
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Matsuoka
authors.affiliation: Department of Internal Medicine, Division of IBD, Tokyo Yamate Medical Center, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.affiliation: Department of gastroenterology, Kanazawa University Hospital, Ishikawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kagaya
authors.affiliation: Department of Gastroenterology and Hepatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Naganuma
authors.affiliation: Division of Internal Medicine, Department of IBD, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hida
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Center for Advanced IBD Research and Treatment, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
authors.affiliation: Department of Internal medicine, Sakura Medical Center, Toho University, Sakura, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Hokari
keywords: Anti tumor necrosis factor-alpha; Inflammatory bowel diseases; Pregnancy outcome; Thiopurines