• PDF / 170,824 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 101 Downloads / 142 Views

DOWNLOAD

REPORT

---

1

S

Preterm delivery and Pierre-Robin sequence: 8 case reports A prospective cohort study of 45 pregnant women, who had exposure to leflunomide during pregnancy or prior to pregnancy and had contacted counselling services of the Organization of Teratology Information Specialists in the US or Canada between 1999 and 2009, described seven women aged 23–43 years and one male infant [exact age not stated], out of whom, the women had preterm delivery following treatment with prednisone during pregnancy, and an infant developed Pierre-Robin sequence secondary to in-utero exposure of leflunomide [dosages and routes not stated]. The women, who had rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), juvenile RA, scleroderma, gestational diabetes or depression, received leflunomide 10–20 mg/day between -2–26.3 weeks of gestation along with prednisone. Four of these seven women received other medications including methotrexate (two women) and unspecified NSAID (two women) [routes not stated; not all dosages stated]. Six of these seven women also received cholestyramine for leflunomide washout procedure. All women had preterm delivery at 35.3 weeks–36.9 weeks of gestation. Five of these seven women delivered live female babies and two women delivered live male babies. One of these seven women had twin pregnancy, out of which one twin was spontaneously aborted [aetiology unknown]. Of the women, who delivered female babies, three infants were doiagnosed to have malformations including short nose, flat nasal bridge, long philtrum (two infants) and aplasia cutis congenital (one infant). Of the two women, who delivered male babies, one infant diagnosed to have Pierre-Robin sequence secondary to in-utero exposure of leflunomide. He also had patent ductus arteriosus, spina bifida occulta, chondrodysplasia punctate and congenital heart block due to unknwn aetiology. Author comment: "[A]s suggested by multivariate analysis in the previous controlled cohort study, the higher rate of preterm delivery is likely to be. . .the concomitant use of oral steroids." "Pierre-Robin sequence . . . is characterized by micrognathia, glossoptosis, and breathing problems (with or without cleft palate) . . . It is possible that leflunomide could have played a causative role in the pathogenesis of this subset of malformations in a single infant." Cassina M, et al. Pregnancy outcome in women exposed to leflunomide before or during pregnancy. Arthritis and Rheumatism 64: 2085-2094, No. 7, Jul 2012. 803434722 Available from: URL: http://doi.org/10.1002/art.34419 - Italy

0114-9954/19/1780-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved

Reactions 23 Nov 2019 No. 1780