Exposition aux immunosuppresseurs in utero [Exposure in utero to immunosuppressives]
Détails
ID Serval
serval:BIB_A51CA95B44E9
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Exposition aux immunosuppresseurs in utero [Exposure in utero to immunosuppressives]
Périodique
Revue Médicale de la Suisse Romande
ISSN
0035-3655
Statut éditorial
Publié
Date de publication
2001
Volume
121
Numéro
4
Pages
283-291
Langue
français
Notes
Publication types: English Abstract ; Journal Article ; Review
Résumé
The number of pregnant women receiving immunosuppressive therapy is increasing. Use of immunosuppressants during pregnancy is indicated for anti-rejection therapy in transplantation patients and treatment of autoimmune diseases. Despite the maternal and fetal risks of these pregnancies, the proportion of surviving infants is improving and the possibility that a pregnancy could occur in these women during their childbearing years should be considered. All immunosuppressant drugs and their metabolites cross the placenta, raising questions about the long-term outcome of the children exposed to these agents in utera. There is no increased risk of congenital anomalies. However, there is an elevated incidence of prematurity, intrauterine growth retardation (IUGR) and therefore low birthweight, as well as maternal hypertension and preeclampsia. The most frequent neonatal complications are those associated with prematurity and IUGR, as well as adrenal insufficiency with corticosteroids, immunological disturbances with azathioprine and cyclosporin, and hyperkalemia with tacrolimus. The long-term follow-up of infants exposed to immunosuppressants in utero is still limited and experimental studies raise the question whether there could be an increased incidence at adult age of some pathologies including renal insufficiency, hypertension and diabetes. The follow-up of these infants should be carefully organized and multidisciplinary, taking the perinatal context into account.
Mots-clé
Abnormalities, Drug-Induced/etiology, Aftercare, Autoimmune Diseases/drug therapy, Drug Monitoring, Female, Fetal Growth Retardation/chemically induced, Humans, Hypertension/chemically induced, Immunosuppressive Agents/adverse effects, Infant, Newborn, Maternal-Fetal Exchange, Obstetric Labor, Premature/chemically induced, Pre-Eclampsia/chemically induced, Pregnancy, Pregnancy Complications/drug therapy, Risk Factors, Time Factors, Transplantation Immunology
Pubmed
Création de la notice
20/07/2009 14:32
Dernière modification de la notice
20/08/2019 16:10