Esophageal atresia and prenatal exposure to mycophenolate

Martín, María Cecilia; Cristiano, Edgardo; Villanueva, Maria Mercedes; Bonora, M.; Berguio, N.; Tocci, Ana; Groisman, Boris; Bidondo, María Paz; Liascovich, Rosa; Barbero, Pablo

doi:10.1016/j.reprotox.2014.10.015

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…17 Martin reported on four newborns with esophageal atresia as a feature of MMFE even without the presence of other major craniofacial anomalies. 18 In a review of the typical MMFE, 33% had a congenital heart disease, and of those, cono-truncal or aortic arch defects were the most common. They hypothesized that it could be the result of a disturbance of cranial neural crest migration in exposed infants.…”

Section: Discussionmentioning

confidence: 99%

What Is the Teratogenic Risk of Mycophenolate?

Kylat

2017

J Pediatr Genet

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Mycophenolate is often used in the management of systemic lupus erythematosus. It has often been associated with significant fetal embryopathy, including fetal loss and multiple anomalies. The Food and Drug Administration has directed that women should be counseled regarding this prior to initiating treatment with this drug. Isolated total anomalous pulmonary venous return (TAPVR) is a rare association seen with its use in pregnancy.

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Section: Discussionmentioning

confidence: 99%

What Is the Teratogenic Risk of Mycophenolate?

Kylat

2017

J Pediatr Genet

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“…MPA particularly affects T and B lymphocytes since they rely almost exclusively on de novo purine synthesis. Use of mycophenolate drugs during pregnancy is associated with an increased risk of first trimester pregnancy loss and increased risk of congenital malformations, especially external ear and other facial abnormalities including cleft lip and palate, and anomalies of the distal limbs, heart, esophagus, and kidney [39,40,41]. The FDA classifies these drugs as Category D., i.e., with positive evidence of human fetal risk.…”

Section: Nucleotide Synthesis Inhibitorsmentioning

confidence: 99%

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Ponticelli

Moroni

2018

JCM

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Women affected by autoimmune diseases, organ transplantation, or neoplasia need to continue immunosuppressive treatment during pregnancy. In this setting, not only a careful planning of pregnancy, but also the choice of drugs is critical to preventing maternal complications and minimizing the fetal risks. Some immunosuppressive drugs are teratogenic and should be replaced even before the pregnancy, while other drugs need to be managed with caution to prevent fetal risks, including miscarriage, intrauterine growth restriction, prematurity, and low birth weight. In particular, the increasing use of biologic agents raises the question of their compatibility with reproduction. In this review we present data on the indication and safety in pregnancy of the most frequently used immunosuppressive drugs.

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“…6 Micrognathia and hypertelorism are craniofacial features present in around 31% of reported patients. 1 Malformations in other internal viscera are frequently reported (34%) emerging esophageal atresia as a frequent associated defect 7 (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Fetal proximal and distal limb anomalies following exposure to mycophenolate mofetil during pregnancy: A case report and review of the literature

Abdulaziz

Shemies

Taman

et al. 2021

Lupus

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Background Mycophenolate mofetil (MMF) is currently used in a wide spectrum of autoimmune diseases and has been rendered very effective in the management of systemic lupus erythematosus and lupus nephritis. MMF is known to be teratogenic (FDA category D) and therefore, women in childbearing period receiving MMF should be counselled to use effective contraceptive methods to avoid an unplanned pregnancy. Case A 22-year-old lady accidentally discovered to be pregnant while using MMF as a treatment of lupus nephritis which was replaced later on by azathioprine. After maternal and fetal evaluation, maternal lupus flare was confirmed and multiple fetal skeletal deformities associated with intrauterine growth restriction (IUGR) were diagnosed by 4-dimensional ultrasound. Termination of pregnancy was decided after shared decision making. Conclusion Women in childbearing period should be advised to postpone pregnancy for at least six weeks after stoppage of MMF therapy because of its potential teratogenic effects during pregnancy.

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Esophageal atresia and prenatal exposure to mycophenolate

Cited by 13 publications

References 24 publications

What Is the Teratogenic Risk of Mycophenolate?

What Is the Teratogenic Risk of Mycophenolate?

Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

Fetal proximal and distal limb anomalies following exposure to mycophenolate mofetil during pregnancy: A case report and review of the literature

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