Format

Send to

Choose Destination
J Crohns Colitis. 2019 Jan 1;13(1):12-18. doi: 10.1093/ecco-jcc/jjy142.

Outcome of Pregnancies in Female Patients With Inflammatory Bowel Diseases Treated With Vedolizumab.

Author information

1
Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
2
Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium.
3
Department of Paediatric Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
4
Department of Gastroenterology, Ziekenhuis Oost-Limburg - Campus Sint-Jan, Genk, Belgium.
5
Deparment of Gastroenterology, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium.
6
Department of Gastroenterology, Imeldaziekenhuis, Bonheiden, Belgium.
7
Department of Gastroenterology, Mariaziekenhuis Noord-Limburg, Overpelt, Belgium.
8
Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
9
Department of Gastroenterology, Universiteit ziekenhuis Antwerpen, UZA, Antwerp, Belgium.
10
Department of Gastroenterology, Sint-Trudo Ziekenhuis, Sint-Truiden, Belgium.
11
Department of Gastroenterology, AZ Vesalius, Tongeren, Belgium.
12
Department of Gastroenterology, AZ Sint-Lucas, Gent, Belgium.
13
Department of Gastroenterology, AZ Klina, Brasschaat, Belgium.
14
Department of Gastroenterology, AZ Groeninge, Kortrijk, Belgium.

Abstract

Background and Aims:

Vedolizumab is an IgG1 anti-α4β7 integrin antibody approved for the treatment of inflammatory bowel diseases [IBD], but without clear safety data during conception, pregnancy and nursing. Animal studies showed that mucosal vascular addressin cell adhesion molecule 1 [MAdCAM-1] is expressed by maternal vessels in the placenta and recruits α4β7-expressing cells that are considered important for maternal/fetal tolerance. Blocking this interaction by vedolizumab might affect this process. We aimed to evaluate pregnancy outcomes in vedolizumab-treated female IBD patients.

Methods:

We conducted a retrospective, multicentre Belgian observational study. Details on disease activity, prenatal complications, delivery and neonatal outcome were collected through a case report form.

Results:

Twenty-four pregnancies were reported. Five women had active disease at conception and one patient flared during pregnancy. There were 23 live births. Complications were observed in 25% of pregnancies [premature rupture of membranes, pre-eclampsia, miscarriage, elective termination and stillbirth] and in 35% of infants [prematurity, intra-uterine growth retardation, small for gestational age and congenital malformations including hip dysplasia, pulmonary valve stenosis and Hirschprung's disease]. Vedolizumab was continued throughout pregnancy in two females and stopped in the 1st and 2nd trimester in five and 16 patients, respectively. For live born children, the median [interquartile range] gestational age, weight and Apgar score 5 min after birth were 39 [37-39.6] weeks, 3270 [3080-3585] grams and 10 [9-10], respectively.

Conclusions:

Although several complications were observed, both in mothers and in newborns, no firm conclusions can be drawn. Awaiting prospective and controlled registries, vigilance and strict follow-up of pregnant patients treated with vedolizumab seems mandatory.

PMID:
30281093
DOI:
10.1093/ecco-jcc/jjy142
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center