The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy

J. R. Hutson, J. N. Matlow, M. E. Moretti, G. Koren

Research output: Contribution to journalReview articlepeer-review

58 Scopus citations

Abstract

Maintaining remission of inflammatory bowel disease (IBD) during pregnancy is critical for positive pregnancy outcomes. Conflicting data exist regarding the association between thiopurine use for IBD treatment in pregnancy and adverse pregnancy outcomes and this meta-analysis aims to clarify this association. A meta-analysis was performed of all original human studies reporting outcomes in pregnancy in patients receiving thiopurines. Nine studies satisfied the inclusion criteria and a total of 494 patients with IBD and 2,782 IBD controls were reported. When compared with healthy women, those receiving thiopurines had an increased risk for congenital malformations (RR 1.45; 95% CI 1.071.96; p = 0.02); however, when compared with IBD controls, there was no increased risk (RR 1.37; 95% CI 0.922.05; p = 0.1). These data provide support for thiopurines having a minimal risk, if any, to the fetus.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalJournal of Obstetrics and Gynaecology
Volume33
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Keywords

  • 6-mercaptopurine
  • Azathioprine
  • Meta-analysis
  • Pregnancy

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