scholarly journals Maternal and Fetal Outcomes After Interferon Exposure During Pregnancy: A Systematic Review With Meta-Analysis

2021 ◽  
Vol 3 ◽  
Author(s):  
Mengmeng Zhang ◽  
Shan Fu ◽  
Danfeng Ren ◽  
Yuchao Wu ◽  
Naijuan Yao ◽  
...  
Keyword(s):  
Viral Hepatitis ◽  
Preterm Delivery ◽  
Spontaneous Abortion ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Case Reports ◽  
Meta Analysis ◽  
Maternal Complications ◽  
Exposure During Pregnancy ◽  
Ifn Treatment

Interferon (IFN) treatment is widely applied in viral hepatitis and multiple myeloproliferative diseases. However, there is considerable controversy on how to deal with unintended pregnancy during IFN treatment, even selective termination is suggested by hepatologists. To settle this clinical dilemma, we conducted a systematic review to retrieve all published articles involving IFN exposure during pregnancy up until March 31, 2021. Only 8 case reports that were relevant with outcomes of pregnant women with viral hepatitis exposed to IFN-α were retrieved, and 17 studies reporting pregnancy outcomes after exposure to type I IFNs involving 3,543 pregnancies were eligible for meta-analysis. No birth defect was reported in the case reports of pregnant women with viral hepatitis. The meta-analysis showed that risks of pregnancy outcomes and birth defects were not increased after exposure to IFN-α. Further comprehensive meta-analysis concerning the IFN-α and IFN-β exposure demonstrated that the risks of live birth (OR 0.89, 95% CI: 0.62–1.27), spontaneous abortion (OR 1.09, 95% CI: 0.73–1.63), stillbirth (OR 1.38, 95% CI: 0.51–3.72), preterm delivery (OR 1.24, 95% CI: 0.85–1.81), and maternal complications (OR 0.72, 95% CI: 0.38–1.38) were not increased in patients exposed to IFNs. The pooled estimates of live birth, spontaneous abortion, stillbirth, preterm delivery, and maternal complications were 85.2, 9.4, 0, 7.5, and 6.5%, respectively. Importantly, the risk of birth defects was not increased (OR 0.68, 95% CI: 0.39–1.20) after IFN exposure, with a pooled rate of 0.51%. Therefore, IFN exposure does not increase the prevalence of spontaneous abortion, stillbirth, preterm delivery, and birth defects. Clinical decision should be made after weighing up all the evidence.

PREGNANCY OUTCOMES AFTER EXPOSURE TO TNF-α INHIBITORS FOR THE TREATMENT OF ARTHRITIC DISEASES: A META-ANALYSIS OF OBSERVATIONAL STUDIES

2018 ◽  
Vol 25 (1) ◽  
pp. e53-e56 ◽  
Author(s):  
Kamelia Mirdamadi ◽  
Tim Salinas ◽  
Reza Vali ◽  
Manny Papadimitropoulos ◽  
Micheline Piquette-Miller
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Live Birth ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Therapeutic Abortion ◽  
Tnf Α

Background Autoimmune arthritic diseases affect many women of child-bearing age. Tumour necrosis factor (TNF)-α inhibitors are currently used for the treatment of various immune-mediated diseases during pregnancy. However, there has been no evaluation of safety in the treatment of arthritic diseases during gestation. Objective To analyze the risk of adverse pregnancy and neonatal outcomes after treatment of arthritic diseases with TNF-α inhibitors. Methods Major databases including Ovid MEDLINE, Embase, and Web of Science, were searched inclusive to April 2016. Observational prospective cohort studies evaluating pregnancy outcomes (birth defects, Spontaneous abortion, therapeutic abortion, birth weight, preterm birth, live birth) after exposure to TNF-α inhibitors for the treatment of arthritic diseases during pregnancy were included. Data on pregnancy and neonatal outcomes was extracted from all included studies. A meta-analysis was performed using inverse-variance random effect with a 95% confidence interval (95%CI) and p<0.05. Results Eight prospective studies with comparison groups were included in the meta-analysis. TNF-α inhibitors were associated with significantly higher risks of low birth weight (odds ratio (OR), 1.43; 95%CI, 1.00–2.04) and significantly lower rates of live birth (OR, 0.61; 95%CI, 0.38–0.98). However, birth defects, therapeutic abortion, spontaneous abortion, and preterm birth were not significantly different between the 2 groups. Conclusion Treatment of arthritic diseases with TNF-α inhibitors during pregnancy increases the risk of lower birth weight and decreases the rate of live birth in this population. While duration of treatment and gestational age at exposure may play a role in these outcomes, evaluation of risk versus benefit is crucial in this patient population.

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

scholarly journals Which is better for mothers and babies, fresh or frozen thawed blastocyst transfer?

2020 ◽  
Author(s):  
Meiling Yang ◽  
li Lin ◽  
Chunli Sha ◽  
Taoqiong Li ◽  
Wujiang Gao ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Cochrane Library ◽  
Maternal Complications ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization

Abstract Background: In recent years, there have been emerging many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and freeze-thaw BT, but these couclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods: A meta-analysis was conducted by searching PubMed, Embase, and Cochrane Library until January 2020. Data were extracted independently by two authors. Results: 42 studies, including 12 randomized controlled trials (RCT) met the inclusion criteria. Fresh BT showed lower implantation rate (IR), pregnancy rate (PR), ongoing pregnancy rate (OPR) and higher eptopic pregnancy rate (EPR) compared with frozen-thawed BT consistent with the results of RCT. The risks of moderate or severe ovarian hyperstimulation syndrome (OHSS), placental abruption (PA) and preterm were higher in fresh BT than in the frozen-thawed BT. The risk of pregnancy-induced hypertension (PIH) and pre-eclampsia was decreased in fresh BT , however, no significant differences of risks for PIH, pre-eclampsia, OHSS, and preterm was found between the two group in the 2 RCT included. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age (SGA) and low birth weight (LBW). No differences in the incidences of neonatal mortality and neonatal malformations were observed between fresh and frozen-thawed BT. Conclusions: In summary, Considering the higher IR, PR, OPR, lower EPR, and the decreased risks of OHSS, PA and preterm, as well as the incidences of SGA and LBW in frozen-thawed BT, this meta-analysis indicates that frozen-thawed BT may be a better choice for mothers and babies compared with fresh BT. Key words: Fresh blastocyst transfer, frozen thawed blastocyst transfer, pregnancy outcome, maternal complications, neonatal outcomes

scholarly journals Pregnancy outcomes after spontaneous conception with previous spontaneous abortion preceding present pregnancy

2021 ◽  
Vol 10 (8) ◽  
pp. 3035
Author(s):  
Shree Kant Dadheech ◽  
Meenakshi K. Bharadwaj ◽  
Brig Aruna Menon
Keyword(s):  
Preterm Delivery ◽  
Spontaneous Abortion ◽  
Pregnancy Outcomes ◽  
Previous History ◽  
Fetal Loss ◽  
Intrauterine Death ◽  
Spontaneous Conception ◽  
Increased Risk ◽  
History Of ◽  
Present Pregnancy

Background: The objective of the present study was to study pregnancy outcomes in patients with Spontaneous conception with history of previous spontaneous abortion preceding present pregnancy.Methods: A prospective study included patients with spontaneous conception with history of previous spontaneous abortion preceding present pregnancy admitted in the department of obstetrics and gynecology, command hospital, Pune between October 2018 and April 2020. The patients were booked (minimum 3 visits in antenatal outdoor clinic) or admitted for the first time as an emergency. The detailed history about previous abortions was taken and routine as well as investigations for possible etiologies of previous abortions were done. Cases with history of mid-trimester abortion were investigated for cervical incompetence. All the patients were observed for complications during present pregnancy like threatened abortion, preeclampsia, preterm labour, intrauterine death and final outcome.Results: A total of 110 patients with history of previous spontaneous abortion were admitted, all patients were booked. Majority (51.8 %) of patients belong to the age group 25-30 years. All patients were with history of previous one abortion followed by pregnancy with spontaneous conception. The final outcomes were term live birth (86.4%), abortion (8.2%), preterm delivery (5.4%), and no still birth. Caesarian section was done in 32.7% patients for various indications.Conclusions: Previous history of spontaneous abortion is associated with adverse pregnancy outcome. There is increased risk of abortion, preterm delivery, need for caesarean sections and fetal loss in cases of previous spontaneous abortions. These complications and fetal loss can be reduced by booking the patients and giving due antenatal care.

scholarly journals Successful Vaginal Delivery after External Cephalic Version in a Woman with a Large Partial Uterine Septum

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kristen E. Park ◽  
Nicole L. Vestal ◽  
Michael S. Awadalla ◽  
Sharon A. Winer
Keyword(s):  
Preterm Delivery ◽  
Vaginal Delivery ◽  
Spontaneous Abortion ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Full Term ◽  
External Cephalic Version ◽  
Vaginal Deliveries ◽  
Uterine Septum ◽  
Adverse Pregnancy

Septate uteri have been associated with adverse pregnancy outcomes including spontaneous abortion, preterm delivery, and malpresentation. It is unclear if uterine septa are associated with infertility. Although some studies have shown improved pregnancy outcomes after septum resection, indications for resection are not well established. We describe a case of a woman with a large partial uterine septum diagnosed during workup for infertility who conceived without septum resection. Both of her subsequent pregnancies were initially breech presentations for which the patient underwent external cephalic version followed by full-term vaginal deliveries. This case adds evidence that an unresected uterine septum should not be considered a contraindication to external cephalic version.

scholarly journals Pregnancy outcomes from the global pharmacovigilance database on interferon beta-1b exposure

2020 ◽  
Vol 13 ◽  
pp. 175628642091031 ◽  
Author(s):  
Kerstin Hellwig ◽  
Fernando Duarte Caron ◽  
Eva-Maria Wicklein ◽  
Aasia Bhatti ◽  
Alessandra Adamo
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Spontaneous Abortion ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Congenital Anomalies ◽  
Interferon Beta ◽  
Live Births ◽  
Congenital Birth Defects ◽  
Pharmacovigilance Database

Background: The goal of the present cohort study was to review outcomes of patients exposed to interferon beta-1b during pregnancy. Methods: Pregnancy cases with exposure to interferon beta-1b reported to Bayer’s pharmacovigilance (PV) database from worldwide sources from January 1995 through February 2018 were retrieved for evaluation. Only cases where pregnancy outcomes were unknown at the time of reporting (i.e. prospective cases) were included in the analysis of this retrospective cohort study. Results: As of February 2018, 2581 prospective pregnancies exposed to interferon beta-1b were retrieved from the database; 1348 pregnancies had documented outcomes. The majority of outcomes [1106 cases (82.0%)] were live births. Health status was known for 981 live births (no known health status for 125). Most of the prospective pregnancies with known outcomes corresponded to live births with no congenital anomalies [896 cases (91.3%)]. Spontaneous abortion occurred in 160 cases (11.9%). Congenital birth defects were observed in 14/981 live births with known health status [1.4%, 95% confidence interval (CI) 0.78–2.38]. No consistent pattern in the type of birth defect was identified. Rates of both spontaneous abortion and birth defects were not higher than the general population. Conclusions: These PV data, the largest sample of interferon beta-1b-exposed patients reported to date, suggest no increase in risk of spontaneous abortion or congenital anomalies in women exposed during pregnancy.

scholarly journals Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Meiling Yang ◽  
Li Lin ◽  
Chunli Sha ◽  
Taoqiong Li ◽  
Wujiang Gao ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Blastocyst Transfer ◽  
Cochrane Library ◽  
Maternal Complications ◽  
Ongoing Pregnancy Rate

Abstract Background In recent years, there have been many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and frozen-thawed BT, but the conclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in the context of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods A meta-analysis was conducted by searching the PubMed, Embase, and Cochrane Library databases through May 2020. Data were extracted independently by two authors. Results Fifty-four studies, including 12 randomized controlled trials (RCTs), met the inclusion criteria. Fresh BT was associated with a lower implantation rate, pregnancy rate, ongoing pregnancy rate, and clinical pregnancy rate and higher ectopic pregnancy rate than frozen-thawed BT according to the results of the RCTs. The risks of moderate or severe ovarian hyperstimulation syndrome, placental abruption, placenta previa and preterm delivery were higher for fresh BT than for frozen-thawed BT. The risk of pregnancy-induced hypertension and pre-eclampsia was lower for fresh BT; however, no significant differences in risks for gestational diabetes mellitus and preterm rupture of membrane were found between the two groups. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age and low birth weight. No differences in the incidences of neonatal mortality or neonatal malformation were observed between fresh and frozen-thawed BT. Conclusions At present there is an overall slight preponderance of risks in fresh cycles against frozen, however individualization is required and current knowledge does not permit to address a defintive response.

Sign in / Sign up

Export Citation Format

Share Document