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09:11
A Mouse Model of in Utero Transplantation
Published on: January 27, 2011
[Exposure in utero to immunosuppressives]
A Prévot1, S Martini, J P Guignard
1Service de pédiatrie, Unité de néphrologie, CHUV, Lausanne. prevotanne@hotmail.com
Revue Medicale De La Suisse Romande
|June 13, 2001
Summary
Pregnancy with immunosuppressants increases risks like prematurity and low birthweight, but congenital anomalies are not more common. Careful monitoring of infants exposed to immunosuppressive drugs in utero is crucial for long-term health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Pharmacology
Context:
- Increasing use of immunosuppressive therapy in pregnant women for transplantation and autoimmune diseases.
- Recognition of potential maternal and fetal risks associated with these pregnancies.
- Improving infant survival rates necessitate consideration of pregnancy in women of childbearing age on immunosuppressants.
Purpose:
- To review the implications of immunosuppressant drug use during pregnancy.
- To outline the risks and neonatal complications associated with in utero exposure.
- To emphasize the need for long-term follow-up of exposed infants.
Summary:
- All immunosuppressants cross the placenta; no increased risk of congenital anomalies observed.
- Elevated incidence of prematurity, intrauterine growth retardation (IUGR), low birthweight, maternal hypertension, and preeclampsia.
- Neonatal complications include issues related to prematurity/IUGR, adrenal insufficiency (corticosteroids), immunological disturbances (azathioprine, cyclosporine), and hyperkalemia (tacrolimus).
Impact:
- Limited long-term follow-up data exists, but experimental studies suggest potential for adult-onset pathologies like renal insufficiency, hypertension, and diabetes.
- Highlights the critical need for organized, multidisciplinary, and perinatal-context-aware follow-up for infants exposed to immunosuppressants in utero.
- Informs clinical practice regarding risk assessment and management strategies for pregnant patients on immunosuppressive medications.
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