Glycated Albumin in Pregnancy: Reference Intervals Establishment and Its Predictive Value in Adverse Pregnant Outcomes

2019 ◽  
Author(s):  
Ying Dong ◽  
Yanhong Zhai ◽  
Jing Wang ◽  
Xin Xie ◽  
Chunhong Zhang ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Glycated Albumin ◽  
Late Pregnancy ◽  
Reference Intervals ◽  
Diabetic Patients ◽  
Third Trimester ◽  
The Third ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract Background As one of the most common pregnant complications, the gestational diabetes mellitus (GDM) is associated with significant adverse pregnant outcomes and it is crucial to accurately monitor the glycemic states of GDM patients. The HbA1c which is a traditional long-term glycemic marker used in diabetic patients, is not recommended in GDM patients during pregnancy. Recently, many efforts have been focused on the alternative marker glycated albumin (GA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GA in healthy Chinese pregnant women and to assess the predictive value of serum GA in adverse pregnant outcomes. Methods Totally 479 healthy subjects including 153 in the first trimester, 174 in the second trimester, and 152 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GA. The diagnostic value of GA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24-28 weeks of gestation. The association between GA in the late pregnancy and the adverse pregnant outcomes was analyzed retrospectively with the data collected from January to June 2018 at our hospital. Results The estimated RIs of GA in present study were 10.87-15.09 %, 10.04-13.50 %, and 9.78-13.03 % in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GA and 0.705 for FPG. More importantly, the GA levels of the third trimester did not show significant changes in women with large-for-date birth weight, preterm delivery, postpartum hemorrhage or hypertension when compared in women with normal pregnancy outcomes. The exception was that the GDM patients who developed preeclampsia did have a lower GA level in their late pregnancy. Conclusions Our results show that the GA was continuously decreased as the gestational age went up. It has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

scholarly journals Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ying Dong ◽  
Yanhong Zhai ◽  
Jing Wang ◽  
Yi Chen ◽  
Xin Xie ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Glycated Albumin ◽  
Reference Intervals ◽  
Adverse Pregnancy Outcomes ◽  
Third Trimester ◽  
The Third ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract Background Many efforts have been focused on the alternative glycemic marker glycated albumin (GlyA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GlyA in healthy Chinese pregnant women and to assess the predictive value of serum GlyA in adverse pregnancy outcomes. Methods Totally 421 healthy subjects including 137 in the first trimester, 152 in the second trimester, and 132 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GlyA. In addition, 67 pregnant women diagnosed with GDM were enrolled at 24–28 weeks of gestation. The diagnostic value of GlyA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24–28 weeks of gestation. The association between GlyA in the late pregnancy and the adverse pregnancy outcomes was analyzed with the data collected from January to June 2018 at our hospital. Results The estimated RIs of GlyA in present study were 11.26–15.10%, 10.04–13.50%, and 9.76–13.09% in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GlyA and 0.705 for FPG. More importantly, the GlyA level in the third trimester was not more elevated in the patients with adverse pregnancy outcomes including large for gestational age (LGA), preterm delivery, hypertension and preeclampsia (PE). The exception was made with the GDM patients who suffered from postpartum hemorrhage and had significantly higher GlyA levels than the control group. Conclusions Our results showed that the GlyA was continuously decreased as the gestational age went up. The GlyA testing has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

scholarly journals Association Between Gestational Weight Gain in Women With Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Ping Shi ◽  
Aimin Liu ◽  
Xiaoyan Yin
Keyword(s):  
Preterm Birth ◽  
Relative Risk ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
The Third ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract Purpose: To examine the association between gestational weight gain (GWG) in women with gestational diabetes mellitus (GDM) and adverse pregnancy outcomes (APOs).Methods: This retrospective cohort study enrolled women with GDM and singleton live birth pregnancies who delivered between January 2010 and December 2020. Univariable and multivariable logistic regression analyses were used to determine the association between GWG outside the Institute of Medicine (IOM) guidelines and APOs.Results: Overall, 1606 women with GDM fulfilled the inclusion criteria. After adjusting for confounders, total GWG above IOM guidelines in pregnancy was associated with an increased risk of caesarean delivery [adjusted odds ratio (aOR)=1.34, 95% confidence interval (CI): 1.04-1.72], hypertensive disorders of pregnancy (HDP) (aOR=2.00, 95% CI: 1.28-3.12), preeclampsia (aOR=2.06, 95% CI: 1.01-3.12), macrosomia (aOR=1.55, 95% CI: 1.13-2.13) and LGA (aOR=1.83, 95% CI: 1.43-2.10), and a decreased risk of premature rupture of membrane (PROM) (aOR=0.46, 95% CI: 0.36-0.60) and preterm birth (aOR=0.35, 95% CI: 0.26-0.44); total GWG below IOM guidelines in pregnancy was associated with an increased relative risk of preterm birth (aOR=1.96, 95% CI: 1.44-2.66) and SGA (aOR=1.32, 95% CI: 1.11-1.50) and a decreased relative risk of macrosomia (aOR=0.35, 95% CI: 0.23-0.53). Further, in both second and third trimesters of pregnancy, GWG above IOM guidelines was found to be associated with a high risk of HDP (aOR=2.55, 95% CI: 1.86-3.38; aOR=1.93, 95% CI: 1.08-2.98), preeclampsia (aOR=2.28, 95% CI: 1.21-3.81; aOR=2.17, 95% CI: 1.35-4.37), macrosomia (aOR=1.20, 95% CI: 1.02-1.82; aOR=2.02, 95% CI: 1.51-2.64) and LGA (aOR=1.65, 95% CI: 1.36-2.04; aOR=1.88, 95% CI: 1.62-2.18). GWG above IOM guidelines in the third trimester of pregnancy also increased the risk of caesarean delivery (aOR=1.48, 95% CI: 1.16-2.34). While GWG below IOM guidelines in both second and third trimesters of pregnancy was associated with a decreased relative risk of macrosomia (aOR=0.66, 95% CI: 0.52-0.78; aOR=0.52, 95% CI: 0.39-0.63). In addition, GWG below IOM guidelines in the third trimester of pregnancy was associated with an increased relative risk of preterm birth (aOR=1.52, 95% CI: 1.12-2.05) and SGA (aOR=1.21, 95% CI: 1.10-1.69).Conclusion: GWG, outside the IOM guidelines has increased risks of APOs among women with GDM, implying that careful surveillance for GWG during different stages of pregnancy is warranted.

Favorable pregnancy outcomes following continual intramuscular lorazepam use in late pregnancy

2013 ◽  
Vol 3 (2) ◽  
pp. 96-98
Author(s):  
Karen E. Moeller
Keyword(s):  
Case Report ◽  
Pregnancy Outcomes ◽  
Late Pregnancy ◽  
Pregnant Patient ◽  
High Dose ◽  
Third Trimester ◽  
The Third

Use of benzodiazepines during pregnancy is controversial due to conflicting studies in the literature. Furthermore, few published reports on continual use of parenteral benzodiazepines during the third trimester of pregnancy have been published. This case report evaluates the use of high-dose intramuscular lorazepam in a pregnant patient during her last three weeks of gestation.

scholarly journals Association between gestational weight gain in women with gestational diabetes mellitus and adverse pregnancy outcomes: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ping Shi ◽  
Aimin Liu ◽  
Xiaoyan Yin
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract Background To examine association between gestational weight gain (GWG) in women with gestational diabetes mellitus (GDM) and adverse pregnancy outcomes (APOs). Methods This retrospective cohort study enrolled women with GDM who delivered at 2010–2020 in Changzhou, Jiangsu. Total GWG, rates of GWG in second trimester and third trimesters were stratified into three categories according to IOM guidelines: within, below, and above IOM guidelines. Univariable and multivariable logistic regression analyses were used. Results Overall, 1606 women with GDM fulfilled inclusion criteria. Compared with within IOM guidelines and after adjusting for confounders, total GWG above IOM guidelines in pregnancy was associated with an increased odds of caesarean delivery [adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI): 1.04–1.72], hypertensive disorders of pregnancy (HDP) (aOR = 2.00, 1.28–3.12), preeclampsia (aOR = 2.06, 1.01–3.12), macrosomia (aOR = 1.55, 1.13–2.13) and large for gestational age (LGA) (aOR = 2.82, 1.94–3.23), and a decreased odds of premature rupture of membrane (PROM) (aOR = 0.46, 0.36–0.60) and preterm birth (aOR = 0.35, 0.26–0.44); total GWG below IOM guidelines in pregnancy was associated with an increased risk of preterm birth (aOR = 1.96, 1.44–2.66), small for gestational age (SGA) (aOR = 1.32, 1.11–1.50) and a decreased odds of macrosomia (aOR = 0.35, 0.23–0.53) and LGA (aOR = 0.54, 0.42–0.72). Further, in both second and third trimesters of pregnancy, rates of GWG above IOM guidelines was found to be associated with a high odds of HDP (aOR = 2.55, 1.86–3.38; aOR = 1.93, 1.08–2.98), preeclampsia (aOR = 2.28, 1.21–3.81; aOR = 2.17, 1.35–4.37), macrosomia (aOR = 1.20, 1.02–1.82; aOR = 2.02, 1.51–2.64) and LGA (aOR = 1.42, 1.24–1.97; aOR = 1.79, 1.51–2.54). Rates of GWG above IOM guidelines in third trimester of pregnancy also increased odds of caesarean delivery (aOR = 1.48, 1.16–2.34) when compared with within IOM guidelines. While rates of GWG below IOM guidelines in both second and third trimesters of pregnancy was associated with a decreased odds of macrosomia (aOR = 0.66, 95% CI: 0.52–0.78; aOR = 0.52, 0.39–0.63) and LGA(aOR = 0.71, 0.51–0.82; aOR = 0.67, 0.55–0.79). In addition, rate of GWG below IOM guidelines in third trimester of pregnancy was associated with an increased odds of preterm birth (aOR = 1.52, 1.12–2.05) and SGA (aOR = 1.21, 1.10–1.69). Conclusion GWG, outside IOM guidelines has increased risks of APOs among women with GDM, implying that careful surveillance for GWG during different stages of pregnancy is warranted.

scholarly journals Asuhan Kebidanan pada Ibu Hamil Trimester III dengan Anemia

2021 ◽  
Vol 1 ◽  
pp. 1669-1673
Author(s):  
Lutfiah Febriana ◽  
Nina Zuhana
Keyword(s):  
Pregnant Women ◽  
Normal Limit ◽  
Late Pregnancy ◽  
Hemoglobin Level ◽  
The Body ◽  
Third Trimester ◽  
The Third ◽  
Mild Anemia ◽  
In Pregnancy

AbstractAnemia is a condition where the level of hemoglobin in the blood is less than the normal limit (<12 g%) caused by a lack of iron in the body due to malnutrition. While anemia in pregnancy is a condition where the hemoglobin level in pregnant women is <11gr% or <10.5gr% in third trimester pregnant women which generally occurs due to the hemodilution process. The purpose of this case to find out the cause of anemia in late pregnancy and the treatment that can be done to prevent complications that occur with care to routinely consume blood-added tablets (Fe) and recommend foods high in iron. This care design used a comprehensive care method for pregnant women in the third trimester who experience mild anemia (haemoglobin <10,5gr%) in Kalimade Village, Kesesi District, Pekalongan Regency. The results of this care showed an increase in hemoglobin levels in the mother. The conclusion of this case study shows that regularly consuming Fe tablets can increase hemoglobin levels in the blood so that it can prevent and treat anemia. For this reason, pregnant women are expected to routinely consume Fe tablets during pregnancy and midwives are expected to provide education about the benefits of Fe tablets to pregnant women to prevent anemia.Keywords: Haemoglobin; Anemia; Pregnancy AbstrakAnemia merupakan suatu kondisi dimana kadar haemoglobin dalam darah kurang dari batas normal (<12 gr%) yang disebabkan karena kurangnya zat besi didalam tubuh akibat kurang gizi. Sedangkan anemia pada kehamilan adalah kondisi dimana kadar haemoglobin pada ibu hamil <11gr% atau <10,5gr% pada ibu hamil trimester III yang umumnya terjadi karena adanya proses hemodilusi. Tujuan dari kasus ini yaitu untuk mengetahui penyebab terjadinya anemia pada kehamilan lanjut serta penanganan yang dapat dilakukan guna mencegah terjadinya komplikasi yang mungki terjadi dengan asuhan untuk rutin mengkonsumsi tablet tambah darah (Fe) serta anjuran mengkonsumsi makanan tinggi zat besi. Rancangan Asuhan ini menggunakan metode asuhan komprehensif pada ibu hamil trimester III yang mengalami anemia ringan (Haemoglobin <10,5gr%) di Desa Kalimade Kecamatan Kesesi Kabupaten Pekalongan. Hasil asuhan ini menunjukan adanya peningkatan kadar haemoglobin pada ibu. Simpulan studi kasus ini menunjukan bahwa dengan rutin mengkonsumsi tablet Fe dapat meningkatkan kadar Haemoglobin dalam darah sehingga dapat mencegah serta mengobati anemia. Untuk itu ibu hamil diharapkan agar rutin mengkonsumsi tablet Fe selama kehamilan. Bidan diharapkan agar bisa memberikan edukasi tentang manfaat tablet Fe pada ibu hamil guna mencegah terjadinya anemia.Kata kunci: Haemoglobin; Anemia; Kehamilan

scholarly journals SEROPREVALENCE AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION IN THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

2020 ◽  
Author(s):  
Francesca Crovetto ◽  
Fàtima Crispi ◽  
Elisa Llurba ◽  
Francesc Figueras ◽  
María Dolores Gómez-Roig ◽  
...  
Keyword(s):  
Critical Care ◽  
Pregnant Women ◽  
Late Pregnancy ◽  
Clinical Diagnostics ◽  
Clinical Spectrum ◽  
Third Trimester ◽  
Symptomatic Infection ◽  
Susceptibility To Infection ◽  
The Third ◽  
In Pregnancy

IntroductionCase registries of pregnant women diagnosed with coronavirus disease (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection, but up to 9% may require critical care.1 Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection or increased disease severity in late pregnancy.2 Seroprevalence studies may allow reliable estimates of the susceptibility to infection and clinical spectrum since they include asymptomatic and mild infections not tested for PCR. We evaluated the seroprevalence and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women in the first and third trimester.MethodsThe study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks’ gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested (COVID-19 VIRCLIA® Monotest, Vircell Microbiologist, Spain; reported sensitivity 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS® Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the χ2 test or Student t-test as appropriate (p<0.05).ResultsA total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia and 8 (6.4%) dyspnea. Overall, 7 women (5.6%) were admitted for persistent fever (>38°) despite paracetamol and dyspnea, of which 3 had signs of pneumonia on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection, hospital admission or dyspnea were significantly higher in third trimester women (Table and Figure).DiscussionThe 14.3% seroprevalence of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona.5 The data confirm that COVID-19 is asymptomatic in the majority of pregnant women6 and illustrate the value of seroprevalence studies to capture the high proportion of asymptomatic or mild infections. In this study, none of the 125 pregnant women with SARS-CoV-2 infection required critical care as compared to 9% reported in cases diagnosed with PCR.1 However, the proportion of infections with symptoms or dyspnea was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum.1These results provide reassuring information that, even in settings with a high prevalence, SARS-CoV-2 infection in pregnancy mostly presents with asymptomatic or mild clinical forms. The susceptibility to infection seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence studies in pregnancy.

THE DIURNAL PATTERN OF 17β-OESTRADIOL IN PREGNANCY

1972 ◽  
Vol 69 (2) ◽  
pp. 410-412 ◽  
Author(s):  
Alan K. Munson ◽  
Michael E. Yannone ◽  
J. Robert Mueller
Keyword(s):  
Diurnal Variation ◽  
Plasma Levels ◽  
Late Pregnancy ◽  
Diurnal Pattern ◽  
Third Trimester ◽  
The Third ◽  
Present Concept ◽  
Late Evening ◽  
In Pregnancy

ABSTRACT Plasma unconjugated 17β-oestradiol was measured at 8 a.m., 4 p.m. and 10 p. m. in eleven normal females during the third trimester of pregnancy. The late evening values were significantly lower than those observed at 8 a. m. Marked differences in plasma levels were noted for some individuals at the three periods of sampling. A slight diurnal variation in plasma 17β-oestradiol appears compatible with the present concept of oestrogen biosynthesis in late pregnancy.

scholarly journals Acute Fetal Demise with First Trimester Maternal Infection Resulting from Listeria monocytogenes in a Nonhuman Primate Model

mBio ◽  
2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Bryce Wolfe ◽  
Gregory J. Wiepz ◽  
Michele Schotzko ◽  
Gennadiy I. Bondarenko ◽  
Maureen Durning ◽  
...  
Keyword(s):  
Nonhuman Primate ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Bacterial Burden ◽  
Third Trimester ◽  
Nonhuman Primate Model ◽  
Primate Model ◽  
Fetal Demise ◽  
The Third ◽  
Adverse Pregnancy

ABSTRACT Infection with Listeria monocytogenes during pregnancy is associated with miscarriage, preterm birth, and neonatal complications, including sepsis and meningitis. While the risk of these conditions is thought to be greatest during the third trimester of pregnancy, the determinants of fetoplacental susceptibility to infection, the contribution of gestational age, and the in vivo progression of disease at the maternal-fetal interface are poorly understood. We developed a nonhuman primate model of listeriosis to better understand antecedents of adverse pregnancy outcomes in early pregnancy. Four pregnant cynomolgus macaques ( Macaca fascicularis ) received a single intragastric inoculation between days 36 and 46 of gestation with 10 7  CFU of an L. monocytogenes strain isolated from a previous cluster of human listeriosis cases that resulted in adverse pregnancy outcomes. Fecal shedding, maternal bacteremia, and fetal demise were consistently noted within 7 to 13 days. Biopsy specimens of maternal liver, spleen, and lymph node displayed variable inflammation and relatively low bacterial burden. In comparison, we observed greater bacterial burden in the decidua and placenta and the highest burden in fetal tissues. Histopathology indicated vasculitis, fibrinoid necrosis, and thrombosis of the decidual spiral arteries, acute chorioamnionitis and villitis in the placenta, and hematogenous infection of the fetus. Vascular pathology suggests early impact of L. monocytogenes infection on spiral arteries in the decidua, which we hypothesize precipitates subsequent placentitis and fetal demise. These results demonstrate that L. monocytogenes tropism for the maternal reproductive tract results in infection of the decidua, placenta, and the fetus itself during the first trimester of pregnancy. IMPORTANCE Although listeriosis is known to cause significant fetal morbidity and mortality, it is typically recognized in the third trimester of human pregnancy. Its impact on early pregnancy is poorly defined. Here we provide evidence that exposure to L. monocytogenes in the first trimester poses a greater risk of fetal loss than currently appreciated. Similarities in human and nonhuman primate placentation, physiology, and reproductive immunology make this work highly relevant to human pregnancy. We highlight the concept that the maternal immune response that protects the mother from serious disease is unable to protect the fetus, a concept relevant to classic TORCH ( t oxoplasmosis, o ther, r ubella, c ytomegalovirus, and h erpes) infections and newly illuminated by current Zika virus outbreaks. Studies with this model, using the well-understood organism L. monocytogenes , will permit precise analysis of host-pathogen interactions at the maternal-fetal interface and have broad significance to both recognized and emerging infections in the setting of pregnancy.

scholarly journals Outcomes following biosimilar TNF inhibitors use for inflammatory-mediated immune disorders in pregnancy

2021 ◽  
pp. 1753495X2110287
Author(s):  
R Scott ◽  
H Parker ◽  
S Mccartney ◽  
P Harrow ◽  
D Williams ◽  
...  
Keyword(s):  
Inflammatory Disease ◽  
Pregnancy Outcomes ◽  
Congenital Abnormalities ◽  
Post Partum ◽  
Late Pregnancy ◽  
Immune Mediated ◽  
Adverse Pregnancy ◽  
Biologic Drug ◽  
Necrosis Factor ◽  
In Pregnancy

Background Biosimilar tumour necrosis factor inhibitors (TNFi) are increasingly used to treat inflammatory immune-mediated disorders as they cost less than the originator biologic drug. More women are therefore becoming pregnant on biosimilar TNFi. This is the first paper to explore the safety and efficacy of biosimilar therapies in pregnancy. Methods A retrospective review of clinical data reviewed pregnancy outcomes and inflammatory disease activity in 18 pregnancies where the mother was using a biosimilar TNFi at conception. Results Biosimilar therapy was not associated with congenital abnormalities, preterm birth or other adverse pregnancy outcomes. Stopping biosimilar TNFi in pregnancy was associated with childbirth at an earlier gestation, as well as a flare of inflammatory disease in pregnancy or post-partum. Conclusions Women and clinicians should feel confident in using biosimilar TNFi in early pregnancy, and continuing them through pregnancy to prevent flares in late pregnancy or the early post-partum.

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