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An Update on Biologic Agents During Pregnancy.

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Summary

Most biologic agents are safe for pregnancy, categorized by risk. Individualized treatment considers disease activity and side effects, with specific medications recommended or contraindicated during pregnancy.

Keywords:
Adverse effectsAutoimmune diseaseImmunosuppressive agentsPregnancy

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Area of Science:

  • Obstetrics and Gynecology
  • Rheumatology
  • Immunology

Background:

  • Biologic agents are increasingly used for various conditions.
  • Understanding the safety of these agents during pregnancy is crucial for patient care.
  • Risk stratification of biologic agents is necessary for informed treatment decisions.

Purpose of the Study:

  • To review the safety of biologic agents during pregnancy.
  • To categorize biologic agents based on their risk profiles.
  • To provide guidance on the use of medications during pregnancy for autoimmune diseases.

Main Methods:

  • Literature review of biologic agents and their use in pregnancy.
  • Categorization of medications into risk groups: minimal, uncertain, moderate, and high.
  • Analysis of specific drug safety data, including teratogenicity and pregnancy complications.

Main Results:

  • Most biologic agents are considered safe in pregnancy, with specific categories of risk identified.
  • Hydroxychloroquine, sulfasalazine, azathioprine, cyclosporine A, and low-dose aspirin are deemed safe.
  • Glucocorticoids may increase risks of gestational diabetes and hypertension; NSAIDs are limited to early pregnancy.
  • Tumor necrosis factor-α inhibitors show minimal risk, while methotrexate, mycophenolate, and leflunomide are contraindicated.

Conclusions:

  • Treatment with biologic agents during pregnancy should be individualized based on disease activity and risk assessment.
  • Certain medications are safe, while others pose significant risks and are contraindicated.
  • Close monitoring and careful selection of therapies are essential for managing pregnant patients.