Advertisement

Maternal Use of Drugs for Inflammatory Intestinal Disease and Infant Congenital Malformations

  • Bengt Källén
Chapter

Abstract

Drugs for inflammatory intestinal disease are generally regarded as non-teratogenic but an association between the use of 5-aminosalicylic acid drugs and congenital malformations, notably congenital heart defects, seems to exist. It appears to be linked to underlying ulcerative colitis and may be an example of confounding by indication. Use of drugs in early pregnancy may be an indicator of a flare of the underlying disease which may cause a disturbed heart morphogenesis. Further information is needed based on large but detailed materials.

References

  1. Ban L, Tata LJ, Fiaschi L, Card T. Limited risks of major congenital anomalies in children of mothers with IBD and effects of medication. Gastroenterology. 2014;146:76–84.CrossRefGoogle Scholar
  2. Bortoli A, Saibeni S, Tatarella M, Prada A, Beretta L, Rivolta R, Politi P, Ravelli P, Imperiali G, Colombo E, Pera A, Daperno M, Carnovali M, de Franchis R, Vecchi M. Pregnancy before and after the diagnosis of inflammatory bowel diseases: retrospective case-control study. J Gastroenterol Hepatol. 2007;22:542–9.CrossRefGoogle Scholar
  3. Boyd HA, Basit S, Harpsøe MC, Wohlfart J, Jess T. Inflammatory bowel disease and risk of adverse pregnancy outcomes. PLoS One. 2015;10:e0129567.  https://doi.org/10.1371/journal.pone.0129567.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Diav-Citrin O, Park YH, Veerasuntharam G, Polachek H, Bologa M, Pastuszak A, Koren G. The safety of mesalamine in human pregnancy: a prospective controlled cohort study. Gastroenterology. 1998;114:23–8.CrossRefGoogle Scholar
  5. Dominitz JA, Young JCC, Boyko EJ. Outcomes on infants born to mothers with inflammatory bowel disease: a population-based cohort study. Am J Gastroenterol. 2002;97:641–8.CrossRefGoogle Scholar
  6. Källén B. Maternal use of 5-aminosalicylates in early pregnancy and congenital malformation risk in the offspring. Scand J Gastroenterol. 2014;44:442–8.CrossRefGoogle Scholar
  7. Marteau P, Tennenbaum R, Elefant E, Lémann M, Cosnes J. Foetal outcome in women with inflammatory bowel disease treated during pregnancy with oral mesalazine microgranules. Aliment Pharmacol Ther. 1998;12:1101–8.CrossRefGoogle Scholar
  8. Mogadam M, Dobbins WO 3rd, Korelitz BI, Ahmed SW. Pregnancy in inflammatory bowel disease: effect of sulfasalazine and corticosteroids on fetal outcome. Gastroenterology. 1981;80:72–6.CrossRefGoogle Scholar
  9. Moskovitz DN, Bodian C, Chapman ML, Marion JF, Rubin PH, Scherl E, Present DH. The effect on the fetus of medications used to treat pregnant inflammatory bowel-disease patients. Am J Gastroenterol. 2004;99:656–61.CrossRefGoogle Scholar
  10. Nørgård B, Fonager K, Pedersen L, Jacobsen BA, Sørensen HT. Birth outcome in women exposed to 5-aminosalicylic acid during pregnancy: a Danish cohort study. Gut. 2003;52:243–7.CrossRefGoogle Scholar
  11. Nørgård B, Pedersen L, Christensen LA, Sørensen HT. Therapeutic drug use in women with Crohn’s disease and birth outcomes: a Danish nationwide cohort study. Am J Gastroenterol. 2007;102:1406–13.CrossRefGoogle Scholar
  12. Rahimi R, Nikfar S, Rezale A, Abdollahi M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol. 2008;25:271–5.  https://doi.org/10.1016/j.reprotox2007.11.010.CrossRefPubMedGoogle Scholar
  13. Willoughby CP, Truelove SC. Ulcerative colitis and pregnancy. Gut. 1980;21:489–74.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bengt Källén
    • 1
  1. 1.Tornblad Institute for Comparative EmbryologyLund UniversityLundSweden

Personalised recommendations