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Prenatal exposure to mycophenolate mofetil: an updated estimate

Chagit Klieger-Grossmann1, David Chitayat, Sharon Lavign

  • 1Motherisk Program, The Hospital for Sick Children, Toronto ON, Canada.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|November 6, 2010
PubMed

Insights

Mycophenolate mofetil (MMF) use in pregnancy may pose risks, but prospective data suggests the absolute teratogenic risk might be lower than previously thought. Close monitoring and diagnostic imaging are recommended for exposed pregnancies.

Area of Science:

  • Pharmacology
  • Teratology
  • Reproductive Medicine

Background:

  • Mycophenolate mofetil (MMF) is a key immunosuppressant for transplant recipients and autoimmune diseases.
  • Case reports indicate MMF exposure during pregnancy may cause congenital malformations.
  • Unplanned pregnancies necessitate a clear understanding of MMF's teratogenic potential.

Purpose of the Study:

  • To prospectively evaluate the teratogenic risk of Mycophenolate mofetil (MMF) exposure during pregnancy.
  • To update the understanding of MMF's safety profile in pregnant women.

Main Methods:

  • Prospective cohort study utilizing the Organization of Teratology Information Specialists (OTIS) network.
  • Identification and follow-up of pregnant women exposed to MMF during embryogenesis.
  • Data collection on pregnancy outcomes, including malformations in live births.

Main Results:

  • Ten pregnancies exposed to MMF during embryogenesis were identified.
  • Four miscarriages and one elective abortion occurred.
  • None of the five live births exhibited congenital malformations.
  • The observed malformation rate may be lower than suggested by initial case reports.

Conclusions:

  • The absolute teratogenic risk of Mycophenolate mofetil (MMF) may be lower than previously estimated from case reports.
  • Specific MMF-associated malformations (e.g., microtia, cleft palate, cardiac defects) can potentially be detected via prenatal imaging.
  • Diagnostic imaging is advised for pregnancies exposed to MMF to assess fetal development.

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