AZA/6-MP in Pregnancy Several studies in transplant recipients have reported safe use during pregnancy1.
{"Image DocumentName": "AZA/6-MP in PregnancySeveral studies in transplant recipients have reported safe use during pregnancy1.", "Image ImageDescription": "Study of IBD patients showed no \uf0ad in prematurity, spontaneous abortion, congenital abnormalities, or childhood neoplasia2. Study population included fathers treated with AZA/6-MP. In another study, AZA/6-MP did not reduce fertility in men3. Risk of birth defects similar to that in general population4. AZA and its active metabolite, 6-MP, are common choices for maintenance therapy in IBD after other agents have been used to induce remission or for patients who have not responded to systemic steroids.1,83 AZA is also used, often with prednisone, by transplant patients.84 A review of pregnancy in women with renal allografts reported no frequent or predominant developmental fetal abnormalities. Those that were reported were rare and often resolved.85 A small study of women with IBD taking AZA reported no congenital abnormalities and no perinatal problems. The authors concluded that AZA is safe in pregnancy for patients with IBD and that termination of pregnancy is not mandatory for patients who conceive while taking the drug.86. A recent, large study assessed outcomes of infants born to 79 mothers with IBD who took AZA/6-MP either before conception, before conception and during pregnancy, or just during pregnancy or to 76 fathers who had been treated before conception.87 Results indicated no significant difference in rates of miscarriage, congenital abnormalities, premature birth, or neonatal and childhood infection between the treated cohort and untreated controls. In another study, semen quality and, thus, fertility in men with IBD was not reduced by treatment with AZA.13. AZA has been found to be relatively safe in pregnancy. In a surveillance study of more than 225,000 pregnancies, no major malformations were observed in 6 categories \u2013 cardiovascular defects, oral cleft, spina bifida, polydactyl, limb reduction defect, and hypospadias.80 Fetal immunosuppression has been observed, including bone marrow suppression, leukopenia, and thrombocytopenia.86 Overall, the risk of a disease flare-up may strongly outweigh the risk of fetal damage, and this issue should be decided by patient and physician in each case.4. 1Briggs GG, et al. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; Francella A, et al. Gastroenterology. 2003;124: Dejaco C, et al. Gastroenterology. 2001;121: Library: IBD & Your Family. Available at  Accessed March 6, 2003.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}