The reproductive effects of beta interferon therapy in pregnancy - A longitudinal cohort

Department of Psychology, University of North Carolina at Chapel Hill, North Carolina, United States
Neurology (Impact Factor: 8.29). 10/2005; 65(6):807-11. DOI: 10.1212/01.wnl.0000180575.77021.c4
Source: PubMed


To determine whether interferon therapy during human pregnancy increases reproductive risks in women.
This longitudinal, controlled cohort study consisted of three groups of women: an exposed group, a disease matched unexposed group, and a healthy comparative group. Subjects were selected from women contacting the Motherisk Program regarding maternal beta interferon exposure, mostly for multiple sclerosis during pregnancy, from 1997 to 2004. After delivery all of the women were re-contacted for a follow-up interview regarding maternal health, pregnancy outcome, and neonatal health.
The study group (n = 16 women, 23 pregnancies) were exposed to interferon beta-1a (Avonex, Rebif) and interferon-1b (Betaseron). There was a decrease in mean birth weight in the exposed group (3,189 +/- 416 g) as compared to healthy controls (3,783 +/- 412 g, p = 0.002). Women exposed to beta interferon had a higher rate of miscarriages and stillbirths (39.1%) vs healthy controls (5%) (p = 0.03), even after correction for potential confounders. There were two major malformations (abnormality in the X chromosome, Down's syndrome) among exposed fetuses.
Beta interferon therapy in the first trimester of pregnancy appears to be associated with an increased risk for fetal loss and low birth weight.

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Available from: Jacob Wolpin, Oct 17, 2014
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    • "Teratogen Information Service (TIS) studies typically identify pregnant women when they call to request counseling about the teratogenic potential of medications or other products and then follow the women to determine pregnancy outcome. Two such controlled prospective cohort studies of IFNβ treatment have been reported, one performed through the Motherisk Program in Toronto (Boskovic et al., 2005) and the other through the Berlin TIS (Weber-Schoendorfer and Schaefer, 2009). Both studies compared pregnancy outcomes in women with MS who were treated with IFNβ, women with MS who were untreated during pregnancy, and non-MS healthy control women. "
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    ABSTRACT: Multiple sclerosis (MS) is the most commonly acquired neurological disorder affecting young adults of reproductive age with an approximately 3:1 female to male ratio. Although pregnancy is not contraindicated in MS, data are limited regarding pregnancy outcome among MS patients, and the safety or risk to the fetus associated with most maternal MS treatments, such as disease modifying therapies (DMTs), during pregnancy is unknown. We review available epidemiological and registry data on MS and pregnancy and discuss the need to initiate a North American Multiple Sclerosis Pregnancy Registry that will prospectively identify pregnancies in women with MS, obtain information on the disease, and its treatment during gestation and lactation and follow the children to determine their health status. Copyright © 2014 Elsevier B.V. All rights reserved.
    Full-text · Article · Jan 2015 · Multiple Sclerosis and Related Disorders
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    • "Other studies have demonstrated the association of changes in other parameters such as lower birth weight [7], shorter gestational period [8], or higher SAB rates [9] in interferon beta-exposed pregnancies. "
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    ABSTRACT: Multiple sclerosis is the most common neurological disease of young adults that causes major disability. In Romania, it is estimated that this disease has a prevalence of 35-40 per 100,000 inhabitants. It is a disease that begins at the age of 20-40 years and is 2-3 times more common in women than in men. More than half of patients with MS develop the disease in their fertile period of life; therefore, MS patients use contraceptive methods while being under our treatment. Since several therapeutic options have been implemented with good efficiency in the disease stabilization, increasingly more patients begin to wonder about the possibility of having a child and about the possible risks of pregnancy. The evolution during pregnancy and the lactation period has been favorable, with lower relapses and side effects comparable to those in the general population. In addition, babies born to mothers with MS have not had a significantly different mean gestational age or birth weight compared to babies born to healthy mothers.
    Full-text · Article · Apr 2014
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    • "Several clinical studies have proven that in utero exposure to IFN-β during pregnancy occurs in patients with MS; however, results regarding the effects of IFN-β on pregnant mothers and newborns have been conflicting.28–32 Boskovic and colleagues reported that exposure to IFN-β in the first trimester increases the risk for miscarriages, stillbirth and low infant birthweight.28 A study by Amato et al. revealed that IFN-β exposure does not increase the risk of spontaneous abortion and is not associated with any significant fetal complications, malformations or developmental abnormalities; however, this study found that IFN-β exposure is associated with low birthweight and shorter length in newborns.29 "
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    ABSTRACT: We herein report a case of a pregnant Chinese woman who suffered an acute exacerbation of hepatitis B. The patient's liver enzymes became elevated toward the end of the first trimester. She was treated with lamivudine, interferon (IFN)-β and steroids early in the second trimester. After this treatment regimen was initiated, aminotransferase levels rapidly normalized within 4 weeks. IFN-β and steroids were administrated for 2 weeks in the second trimester, while the administration of lamivudine continued until delivery. The spontaneous delivery of a female baby weighing 2984 g occurred at 37 weeks of gestation. A neonatal examination revealed no congenital anomalies, and fetal growth was found to be within normal reference ranges. The infant received simultaneous active and passive hepatitis B virus immunization within 12 h of delivery and completed the hepatitis B vaccine schedule at 2, 3 and 5 months of age. The infant was successfully prevented from contracting hepatitis B virus. This case suggests that combination therapy with lamivudine, IFN-β and steroids may be safely used during the second trimester to treat acute exacerbations of hepatitis B.
    Full-text · Article · Apr 2013 · Hepatology Research
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