Neonatal outcomes of children born to mothers on biological agents during pregnancy: state of the art and perspective

Publication date: Available online 6 December 2019Source: Pharmacological ResearchAuthor(s): Rebecca de Lorenzo, Giuseppe A. Ramirez, Daniele Punzo, Laura Lorioli, Rosanna Rovelli, Valentina Canti, Graziano Barera, Patrizia Rovere-QueriniAbstractBiologic disease-modifying anti-rheumatic drugs (bDMARDs) are used in pregnant patients with rheumatic diseases. Long-term follow-up data about newborns exposed to bDMARDs during pregnancy are however scarce. Here we summarize the published evidence and available recommendations for use of bDMARDs during pregnancy. We analyse clinical features at birth and at follow-up of 84 children, including: 16 consecutive children born to mothers with autoimmune diseases exposed to bDMARDs in utero; 32 children born to mothers with autoimmune diseases who did not receive bDMARDs; 36 children born to healthy mothers. In our monocentric cohort, children born to mothers with autoimmune diseases had lower gestational age at birth compared to those born to healthy mothers, independently of exposure to bDMARDs. At multivariate analysis, prematurity was an independent predictor of the need for antibiotic treatment, but not for hospitalisation or neonatal intensive care unit (ICU) stay during the neonatal period. Exposure to bDMARDs during pregnancy does not seem to interfere with post-natal development up to infancy. Prospective studies are needed in larger cohorts of pregnant patients to confirm that bDMARDs do not have a negative impact on psychomotor...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research

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We report a case of PG in a woman whose pregnancy was achieved using egg donation. Since the entire fetal genome is allogeneic to the mother, augmented immune reaction in egg-donated pregnancies appears to trigger the occurrence of PG. PMID: 31950210 [PubMed - as supplied by publisher]
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
Conclusions Patients who develop anti-NMDAR encephalitis during pregnancy or become pregnant during recovery often have obstetrical complications, but most of the newborns are healthy and appear to have normal development.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Autoimmune diseases, Developmental disorders, Neonatal Article Source Type: research
CONCLUSIONS: TAI had no impact on ovarian reserve in euthyroid women and had no association with IVF/ICSI outcomes in women with DOR. Although an increased incidence of congenital anomalies in the positive TAI group was observed in women with NOR, the association between neonatal anomalies and TAI cannot be concluded. Large cohort studies to evaluate the effects of TAI on offspring health are warranted, and further experimental studies are required to explore the underlying mechanisms. PMID: 31928166 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
This study shows that female cells presumed to be MMC are a common phenomenon in adult human brain where they appear to have embedded into brain tissue with the ability to express tissue specific markers.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
The objective of the study was to assess the rate of recurrent pregnancy loss in patients with HT isolated or accompanied with non-endocrine autoimmune diseases. METHODS: This is a retrospective observational cohort study with systematic review of the NEAD with concurrent HT in an outpatient Endocrinology Unit at a University Hospital. Among the 3480 consecutively examined women with HT, 87 patients met the criteria of RPL and represented the study group. Sixty-five of them had isolated HT and 22 women had HT+NEAD. RESULTS: The rate of RPL in women with HT was 2.1% versus 5.64% observed in women with HT+NEAD (OR=2....
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
AbstractBackgroundBisphenol A (BPA) is an environmental estrogen widely exposed to human beings, and there are more studies on its reproductive toxicity, endocrine disruption and neurobehavioral disorders. Recent few studies have found that BPA has immunotoxicity, and its mechanism is not clear. Therefore, the effects of BPA on immune system have attracted extensive attention. The aim of this study was to investigate the effect and mechanism of perinatal exposure to BPA on regulatory T cells (Treg) and Th17 cells in female offspring mice.MethodsTwenty-one pregnant C57BL/6 mice were randomly divided into three groups: a con...
Source: Molecular and Cellular Toxicology - Category: Cytology Source Type: research
Authors: Rodeghiero F, Marranconi E Abstract Introduction: Immune thrombocytopenia (ITP) is an acquired autoimmune disorder, with an incidence rate of 20-40/million adults/year and an estimated prevalence in women of childbearing age of 24.5/million.Areas covered: Authors discuss management of ITP in pregnancy, treatment-related toxicity, delivery, neonatal thrombocytopenia and breastfeeding, and other women's specific issues. Search of papers published between January 1990 and December 2019 was done on PubMed using combinations of the keywords below. Distinction between ITP and other thrombocytopenias in pregnancy...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Women with autoimmune disease (AD) have higher rates of adverse pregnancy outcomes. Smaller fetal thymus size is associated with pregnancy complications and correlates with increased T-regulatory cells in cord blood. This suggests a link between thymus development and immune status at birth. Anti-Tumor Necrosis Factor (TNF) drugs for AD modulate the maternal immune system. The TT-ratio, a previously described quotient of the anterior-posterior thymic and the intrathoracic mediastinal diameter, does not vary by gestational age (GA).
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Poster Session III Source Type: research
Publication date: Available online 19 December 2019Source: Best Practice &Research Clinical RheumatologyAuthor(s): Lisa R. SammaritanoAbstractAntiphospholipid syndrome is an autoimmune systemic disorder characterized by arterial, venous, or small vessel thrombosis and/or recurrent early pregnancy loss, fetal loss, or pregnancy morbidity in the setting of documented persistent antiphospholipid antibodies that include the lupus anticoagulant, or moderate-high titer anticardiolipin, or anti-β2Glycoprotein I antibodies. Associated clinical manifestations include livedo reticularis, cutaneous ulcerations, thrombocytope...
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research
Antiphospholipid antibody syndrome (APS) is an autoimmune disease characterized by thromboembolic events or pregnancy-related complications caused by antiphospholipid antibodies. The following case reports a patient diagnosed with APS, osteoporosis, and atherosclerosis. The medication for treatment and control of the diseases were warfarin, low-molecular-weight heparin, aspirin, and alendronate. Clinical and radiographic examination revealed an intraoral fistula, with spontaneous purulent drainage in a 2-month previous tooth extraction area and signs of bone sequestrum both compatible with medication-related osteonecrosis of the jaw (MRONJ).
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
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