2014
DOI: 10.1002/art.38368
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Pregnancy Outcome After Methotrexate Treatment for Rheumatic Disease Prior to or During Early Pregnancy: A Prospective Multicenter Cohort Study

Abstract: Objective. High-dose methotrexate (MTX) exposure during pregnancy is associated with embryopathy.The teratogenic potential of MTX at dosages typically used in the treatment of rheumatic diseases remains uncertain. The aim of this study was to evaluate the risk of spontaneous abortion, major birth defects, elective termination of pregnancy, shortened gestational age at delivery, and reduced birth weight in women exposed to MTX.Methods. Pregnancy outcome in women taking MTX (<30 mg/week) either after conception … Show more

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Cited by 176 publications
(108 citation statements)
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References 47 publications
(54 reference statements)
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“…As MTX is known to be teratogenic and to induce miscarriages, it should be avoided during pregnancy [87,90]. In general, it is advised to stop MTX 3 months before a planned pregnancy [91]; however, recent evidence suggests that a shorter period might also be appropriate [90].…”
Section: Dmards That Should Be Avoided During Pregnancymentioning
confidence: 99%
See 1 more Smart Citation
“…As MTX is known to be teratogenic and to induce miscarriages, it should be avoided during pregnancy [87,90]. In general, it is advised to stop MTX 3 months before a planned pregnancy [91]; however, recent evidence suggests that a shorter period might also be appropriate [90].…”
Section: Dmards That Should Be Avoided During Pregnancymentioning
confidence: 99%
“…In general, it is advised to stop MTX 3 months before a planned pregnancy [91]; however, recent evidence suggests that a shorter period might also be appropriate [90]. MTX can be detected in small amounts in breast milk and should be stopped because of a theoretical risk [87].…”
Section: Dmards That Should Be Avoided During Pregnancymentioning
confidence: 99%
“…To date, the largest prospective observational study failed to show an increased risk of abnormal pregnancy outcomes (stillbirth, spontaneous abortion, major, and minor birth defects) in women chronically treated with low dose MTX (median weekly dosage 15 mg; range 2.5-30 mg) up to 10 weeks prior to LMP compared to healthy control and disease matched women unexposed to MTX [11]. In contrast, those treated during the first trimester had a higher risk of congenital malformations, although not compatible with the aminopterin syndrome.…”
Section: Managementmentioning
confidence: 90%
“…[87][88][89] A taxa de abortamento durante o tratamento com metotrexato é de aproximadamente 40%, consideravelmente mais elevada do que a observada na população em geral ou mesmo em doentes com doenças autoimunes. 90 Um intervalo mínimo de um a três meses entre a interrupção do metotrexato e a conceção é recomendado. 5,91 O metotrexato é excretado no leite e, embora as concentrações aqui obtidas sejam baixas, pode acumular-se em recém-nascidos com função renal imatura, devendo por isso ser evitado durante a amamentação.…”
Section: Espironolactona (Categoria De Risco C Pela Fda)unclassified