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Five successful pregnancies with antenatal anakinra exposure
Chelsey J F Smith1, Christina D Chambers2
1Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, USA.
Rheumatology (Oxford, England)
|April 17, 2018
Summary
Anakinra (IL-1 inhibitor) use in five pregnancies resulted in healthy outcomes, though two cases of oligohydramnios were noted. Further research is needed on IL-1 inhibitors, maternal fever, and fetal development.
Area of Science:
- Rheumatology
- Immunology
- Obstetrics
Background:
- Limited prospective data exists on Interleukin-1 (IL-1) inhibitor use during pregnancy.
- Anakinra is an IL-1 inhibitor used for autoimmune conditions.
Purpose of the Study:
- To contribute prospective data on the safety and outcomes of anakinra use in pregnancy.
Main Methods:
- Prospective cohort study including 5 pregnancies with anakinra exposure before 19 weeks' gestation.
- Data collected via maternal interview and medical records from 2004-2017.
- Outcomes assessed included birth status, complications, and infant development.
Main Results:
- All 5 pregnancies resulted in full-term singleton live births with no major long-term complications.
- Two mothers developed oligohydramnios; one also had pregnancy-induced hypertension.
- One infant had low birth weight, with normal adjusted weight at 1 year. Three mothers breastfed, two continuing anakinra.
Conclusions:
- Anakinra use was associated with successful pregnancy outcomes in this small cohort.
- Oligohydramnios occurred in two cases, warranting further investigation into IL-1 inhibition, maternal fever, and fetal renal anomalies.
- The relationship between IL-1 inhibitor use, uncontrolled maternal febrile illness, and fetal outcomes requires additional research.
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