Certain Autoimmune Drugs in Pregnancy May Up Newborn Infection Risk: Study
Certain Autoimmune Drugs in Pregnancy May Up Newborn Infection Risk: Study
Colitis therapy tied to 4 cases of low white blood cell count in newborns, but some docs question the finding
Dr. Jonathan Ramprasad, a pediatric gastroenterologist with McLane Children's Scott & White Hospital in Temple, Texas, agreed.
"The treatment is common, safe and state-of-the-art," he said. "It's a very specific biologic intervention that is widely used for many conditions."
Neither doctor participated in the French study cases, all four of which involved the onset of either moderate or severe neutropenia within the first few days or weeks of life.
In the first case, the mother-to-be (aged 24) had been receiving infliximab every seven weeks for two years before becoming pregnant. Once pregnant, her treatment was reduced to once every eight weeks, and then halted altogether at roughly the 27th week of the pregnancy.
The other three cases involved a 28-year-old woman who was pregnant with triplets, and who had also been treated with infliximab until the 27th week of pregnancy.
Antibiotics prompted a full recovery among all four babies within eight to 14 weeks, the study authors reported.
Because neutrophil counts are not normally monitored among children born to mothers receiving anti-TNF treatments, the French researchers suggested that their findings argue in favor of conducting routine white blood cell testing in all such cases, both at birth and throughout the first few weeks of life.
But Hanauer said that the findings "are no reason to be alarmed."
"Yes, these drugs do cross the placenta and get into the baby," he explained. "There's no question about that. But prior studies to date have not demonstrated any increased risk to babies. And this report does not indicate what other medications these mothers were on while pregnant. It's just not mentioned. So we don't know," Hanauer said.
"So, I'd say that the [U.S.] Food and Drug Administration has classified infliximab as a 'Class B' medication, which means it's presumed to be safe. And in the U.S. we have not yet seen any significant cause to change that designation. And the key point is that the best outcome for a baby is a healthy mother during pregnancy," Hanauer added.
"I'm not discounting these findings. But there have been no cases like this reported in the U.S., so they will need to reconfirmed," Hanauer said. "Until then, there is no reason to believe this treatment is not safe for both mother and child."
Pregnancy, Autoimmune Drugs and Infant Infections
Colitis therapy tied to 4 cases of low white blood cell count in newborns, but some docs question the finding
Dr. Jonathan Ramprasad, a pediatric gastroenterologist with McLane Children's Scott & White Hospital in Temple, Texas, agreed.
"The treatment is common, safe and state-of-the-art," he said. "It's a very specific biologic intervention that is widely used for many conditions."
Neither doctor participated in the French study cases, all four of which involved the onset of either moderate or severe neutropenia within the first few days or weeks of life.
In the first case, the mother-to-be (aged 24) had been receiving infliximab every seven weeks for two years before becoming pregnant. Once pregnant, her treatment was reduced to once every eight weeks, and then halted altogether at roughly the 27th week of the pregnancy.
The other three cases involved a 28-year-old woman who was pregnant with triplets, and who had also been treated with infliximab until the 27th week of pregnancy.
Antibiotics prompted a full recovery among all four babies within eight to 14 weeks, the study authors reported.
Because neutrophil counts are not normally monitored among children born to mothers receiving anti-TNF treatments, the French researchers suggested that their findings argue in favor of conducting routine white blood cell testing in all such cases, both at birth and throughout the first few weeks of life.
But Hanauer said that the findings "are no reason to be alarmed."
"Yes, these drugs do cross the placenta and get into the baby," he explained. "There's no question about that. But prior studies to date have not demonstrated any increased risk to babies. And this report does not indicate what other medications these mothers were on while pregnant. It's just not mentioned. So we don't know," Hanauer said.
"So, I'd say that the [U.S.] Food and Drug Administration has classified infliximab as a 'Class B' medication, which means it's presumed to be safe. And in the U.S. we have not yet seen any significant cause to change that designation. And the key point is that the best outcome for a baby is a healthy mother during pregnancy," Hanauer added.
"I'm not discounting these findings. But there have been no cases like this reported in the U.S., so they will need to reconfirmed," Hanauer said. "Until then, there is no reason to believe this treatment is not safe for both mother and child."
