141 Pregnancy Outcome in Inflammatory Bowel Disease for Women Treated with Thiopurine: Cohort from the CESAME Study

Abstract

Introduction Few datas on safety of thiopurines for IBD treatment during pregnancy are available. The aim of this study was to evaluate the pregnancy outcome of women exposed to thiopurines. Patients and methods 215 pregnancies in 204 women were registered and documented in the CESAME cohort between may 2004 and october 2007. Treatment informations included : last menstrual date, delivery term, pregnancy outcome details as spontaneous abortion, therapeutic abortion, prematurity (gestational age of under 37 weeks of gestation), birth weight and height, congenital abnormality, medication history during each trimester, smoking history and ethanol ingestion. Datas were compared between women exposed to thiopurines (thiopurines only or associated with another treatment aminosalicylates, corticosteroids ou anti-TNFa-), womens receiving another drug than thiopurines and patients without any medication. Results The median age of the women was 28.4 years old, 75.7% had a Crohn's disease (CD), 21.8% a ulcerative colitis (UC) and 2.5% an unclassified bowel disease (UIBD), with a mean disease duration of 6.8 years at inclusion. Of 215 pregnancies, there were 138 births (142 newborns because of 4 gemellary pregnancies). 86 of the 215 pregnancies (39.6%) occured with exposure to thiopurines during all or part of the pregnancy, 84 (38.7%) with exposure to other drugs and 45 (20.7%) without any IBD treatment. No significant differences were found among the 3 groups with respect to interrupted pregnancies (36%, 33% et 40% respectively) as seen on table. 29 women with CD were still smoking (18.6%), 2 with UC (2.2%). The mean birth weight was 3135g. Conclusion The results of this large cohort indicate that thiopurine use during pregnancy is not associated with increased congenital abnormalities risk. The increased incidence of hypotrophy and prematurity under thiopurine was not significant and may correlate to the underlying disease.