Immunosuppressive drugs and fetal outcome

• Published in: Best practice & research. Clinical obstetrics & gynaecology 2014-11, Vol.28 (8), p.1174-1187
• Main Authors: Coscia, Lisa A., RN, BSN, CCTC, Constantinescu, Serban, MD, PhD, Davison, John M., MD, Moritz, Michael J., MD, Armenti, Vincent T., MD, PhD
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - chemically induced; Abortion, Spontaneous - epidemiology; Female; fetus; Fetus - drug effects; Humans; immunosuppression; Immunosuppression - adverse effects; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Incidence; Mycophenolic Acid - adverse effects; Obstetrics and Gynecology; Organ Transplantation; Pregnancy; Risk Factors; Teratogenesis - drug effects; transplantation; United States - epidemiology
• ISSN: 1521-6934; 1532-1932
• DOI: 10.1016/j.bpobgyn.2014.07.020

Successful pregnancies have been reported in all types of solid-organ transplant recipients on a variety of immunosuppressive regimens. Immunosuppression is essential to maintain the transplanted organ and maternal health, thus the safety of these medications continues to be studied. This article reviews information in the literature and data from the National Transplantation Pregnancy Registry (NTPR) in the United States related to immunosuppressive medication and pregnancy. Although most maintenance immunosuppressive regimens have not been shown to affect the outcome of posttransplant pregnancies, mycophenolic acid products are associated with an increased incidence of spontaneous abortion and an increase in the incidence and a specific pattern of birth defects. When counseling transplant recipients about the prospect and safety of pregnancy, the health of the mother, her graft, and the developing fetus must all be taken into account.