International multi-centre study of pregnancy outcomes with interleukin-1 inhibitors
International multi-centre study of pregnancy outcomes with interleukin-1 inhibitors
复制标题
DOI：
10.1093/rheumatology/kex305
复制
发表时间：
2017-12-01
期刊：
影响因子：
5.5
通讯作者：
Lachmann, Helen J.
中科院分区：
文献类型：
--
作者：
Youngstein, Taryn;Hoffmann, Patrycja;Lachmann, Helen J.
Objective.提供妊娠期和哺乳期暴露于白细胞介素-1（IL-1）抑制剂的妊娠结局数据。回顾性数据收集自国际系统性自身炎性疾病学会的成员，并在一个中心进行整理。使用统一的数据收集表获得标准化数据，包括母亲年龄和诊断，类型，IL-1阻断的持续时间和反应，妊娠时间，分娩，喂养方式和新生儿发育。来自7个国家的31例母亲暴露妊娠，我们报告了关于父亲暴露的第一批数据：6例暴露于阿那白滞素，5例暴露于卡那单抗，没有负面结果。我们还报告了关于卡那奴单抗暴露妊娠的第一批数据：8例妊娠分娩了7例正常胎龄和出生体重的健康婴儿。有23例阿那白滞素暴露的妊娠导致21名健康婴儿的出生，1名婴儿患有单侧肾发育不全和异位神经垂体。有两个前三个月流产影响母亲与活动性疾病。无严重新生儿感染。14名婴儿接受母乳喂养，无并发症。随访时间长达10年（中位18个月），无发育迟缓的报告。这一系列研究大大增加了已发表的IL-1阻断和生殖经验，包括关于canakinumab和父亲暴露于这些药物的第一个数据。数据通常是令人放心的，虽然肾发育不全的情况下，是第二次报告的阿那白滞素暴露的怀孕。
Objective. To provide outcome data concerning pregnancies exposed to the Interleukin-1 (IL-1) inhibitors prior to conception in both men and women, during pregnancy and breast feeding.Methods. Retrospective data were collected from members of the International Society for Systemic Autoinflammatory diseases and collated in a single centre. A uniform data collection sheet was used to obtain standardized data including maternal age and diagnosis, type, duration of and response to IL-1 blockade, pregnancy duration, delivery, mode of feeding and neonatal development.Results. There were 31 maternal-exposed pregnancies from seven countries and we report the first data on paternal exposure: six to anakinra and five to canakinumab, with no negative outcomes. We also report the first data on canakinumab-exposed pregnancies: eight pregnancies that resulted in the delivery of seven healthy infants of normal gestational age and birthweight. There were 23 anakinra-exposed pregnancies resulting in the birth of 21 healthy infants, and one baby with unilateral renal agenesis and ectopic neurohypophysis. There were two first trimester miscarriages affecting a mother with active disease. There were no serious neonatal infections. Fourteen infants were breast fed with no complications. There were no reports of developmental delay, with follow-up of up to 10 years (median 18 months).Conclusion. This series substantially increases the published experience of IL-1 blockade and reproduction including the first data on canakinumab and on paternal exposure to these agents. Data are generally reassuring, although the case of renal agenesis is the second reported in an anakinra-exposed pregnancy.