Document Detail


Outcomes of pregnancies fathered by inflammatory bowel disease patients exposed to thiopurines.
MedLine Citation:
PMID:  20700117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Immunomodulators are used as maintenance treatment of inflammatory bowel disease (IBD). Data regarding their possible effects in the course of pregnancy when the father is exposed at the time of conception are limited.
METHODS: To evaluate the outcomes of pregnancies of which the fathers were exposed to thiopurines at the time of conception. A series of male patients followed in seven IBD clinics in Madrid, Spain, was studied. Any exposure to thiopurines during the 3 months preceding conception was considered significant. Controls were pregnancies fathered by patients who either had never been treated with thiopurines or had interrupted them >3 months before conception. Statistical comparisons and multivariate analysis were carried out with the generalized estimating equations model.
RESULTS: There were 46 conceptions in the exposed group (mercaptopurine 9, azathioprine 37) and 84 in the control group. In the exposed group, there were more Crohn's patients (82.6% vs. 53.6%), the duration of the disease was longer (median: 8 vs. 5 years), fathers were slightly older (mean: 34.2 vs. 32.7 years), and there were fewer patients on mesalamine (15.2% vs. 47.6%). Otherwise, baseline characteristics were similar in both groups. There were no significant differences regarding unsuccessful pregnancies-namely, spontaneous abortions, ectopic pregnancies, anembryonic pregnancies, or fetal deaths (10.9% exposed group vs. 13.1% control group; odds ratio (OR): 0.79, confidence interval (CI): 0.22-2.85), preterm births (4.3% vs. 2.4%; OR: 1.3, CI: 0.22-7.61), low birth weight (6.5% vs. 6%; OR: 1.06, CI: 0.25-4.54), or congenital malformations (2.2% vs. 2.4%; OR: 0.82, CI: 0.08-9). No infant neoplasms were detected. The proportion of conceptions that needed >1 year to be achieved was higher in the exposed group, but this was not statistically significant (15.2% vs. 8.3%; OR: 1.92, CI: 0.54-6.88). Multivariate analysis was carried out for unsuccessful pregnancies and fertility impairment, and it showed that, although mesalamine exposure confounded the effect of the exposure to thiopurines on these outcomes, this effect was still nonsignificant (respectively, OR: 0.49, CI: 0.17-1.44; OR: 2.82, CI: 0.7-11.38).
CONCLUSIONS: Our data do not support the practice of routinely recommending to male patients that they interrupt thiopurines when wanting to conceive.
Authors:
Carlos Teruel; Antonio López-San Román; Fernando Bermejo; Carlos Taxonera; José Lázaro Pérez-Calle; Javier P Gisbert; María Martín-Arranz; Angel Ponferrada; Manuel Van Domselaar; Alicia Algaba; Jesús Estellés; Pilar López-Serrano; Pablo M Linares; Alfonso Muriel
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-08-10
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-27     Revised Date:  2011-11-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2003-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Hospital Ramón y Cajal, Madrid, Spain. cteruelvegazo@yahoo.es
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MeSH Terms
Descriptor/Qualifier:
6-Mercaptopurine / adverse effects*,  therapeutic use
Azathioprine / adverse effects*,  therapeutic use
Fathers*
Female
Humans
Immunosuppressive Agents / adverse effects,  therapeutic use
Inflammatory Bowel Diseases / drug therapy*
Male
Odds Ratio
Pregnancy
Pregnancy Complications / chemically induced*
Pregnancy Outcome
Spain
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 446-86-6/Azathioprine; 50-44-2/6-Mercaptopurine
Comments/Corrections
Comment In:
Inflamm Bowel Dis. 2011 Nov;17(11):2402-3   [PMID:  21484969 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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