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Exposure toThioguanine During 117 Pregnancies inWomen With Inflammatory Bowel Disease

  • Femke Crouwel*
  • , Melek Simsek
  • , Marjon A. de Boer
  • , Chris J.J. Mulder
  • , Emma M. van Andel
  • , Rob H. Creemers
  • , Dirk P. van Asseldonk
  • , Ad A. van Bodegraven
  • , Carmen S. Horjus
  • , Marijn C. Visschedijk
  • , Angelique L.M. Weusthuis
  • , Margien L. Seinen
  • , Bindia Jharap
  • , Fiona D.M. van Schaik
  • , Ishfaq Ahmad
  • , Paul J. Boekema
  • , Greetje J. Tack
  • , Louktje Wormmeester
  • , Maurice W.M.D. Lutgens
  • , Petra G.A. van Boeckel
  • Lennard P.L. Gilissen, Marjon Kerkhof, Maurice G.V.M. Russel, Frank Hoentjen, Maartje E. Bartelink, Johan P. Kuijvenhoven, Jeroen W.J. Maljaars, Willemijn A. van Dop, Janneke Wonders, Michael M.P.J.A. van der Voorn, Hans J.C. Buiter, Nanne K. de Boer
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Safety of thioguanine in pregnant patients with inflammatory bowel disease [IBD] is sparsely recorded. This study was aimed to document the safety of thioguanine during pregnancy and birth. Methods: In this multicentre case series, IBD patients treated with thioguanine during pregnancy were included. Data regarding disease and medication history, pregnancy course, obstetric complications, and neonatal outcomes were collected. Results: Data on 117 thioguanine-exposed pregnancies in 99 women were collected. Most [78%] had Crohn’s disease and the mean age at delivery was 31 years. In 18 pregnancies [15%], IBD flared. Obstetric and infectious complications were seen in 15% [n = 17] and 7% [n = 8] of pregnancies, respectively. Ten pregnancies [8.5%]

and one in an induced abortion due to trisomy 21. In total, 109 neonates were born from 101 singleton pregnancies and four twin pregnancies. One child was born with a congenital abnormality [cleft palate]. In the singleton pregnancies, 10 children were born prematurely and 10 were born small for gestational age. Screening for myelosuppresion was performed in 16 neonates [14.7%]; two had anaemia in umbilical cord blood. All outcomes were comparable to either the general Dutch population or to data from three Dutch cohort studies on the use of conventional thiopurines in pregnant IBD patients. Conclusion: In this large case series, the use of thioguanine during pregnancy is not associated in excess with adverse maternal or neonatal outcomes.

Original languageEnglish
Pages (from-to)738-745
Number of pages8
JournalJournal of Crohn's and Colitis
Volume17
Issue number5
DOIs
Publication statusPublished - 1 May 2023

Keywords

  • Inflammatory bowel disease
  • pregnancy
  • thioguanine

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