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P443. Infliximab use during pregnancy in Crohn's disease

J. Ramos, D. Carvalho, P. Russo, J. Saiote, G. Ramos, T. Bentes, Hospital Santo António dos Capuchos, Gastroenterology, Lisboa, Portugal

Background

The current standard of care in Crohn's disease resulted in an increased number of pregnancies while on infliximab therapy, and/or the need of its use during gestation. Infliximab is considered to be a low risk drug in pregnancy, but its safety isn't yet fully established.

Methods

To study the effects of infliximab on pregnancy and foetal outcome, we conducted a retrospective review of the clinical records of women with Crohn's disease treated with infliximab during pregnancy. Markers of infliximab's effect on gestation and the foetus were assessed, namely the occurrence of congenital malformations, pregnancy duration and complications, newborns somatometry, mode of delivery, and labour complications.

Results

Nineteen pregnancies in 14 women ocurred while on infliximab maintenance treatment. Three choose to terminate the pregnancy and eleven (5 with 2 pregnancies) continued both gestation and infliximab therapy. Of these 11 women, 2 had disease flares during pregnancy that required hospital admission (one required laparotomy). One woman had a miscarriage and three pregnancies remain in course. In the others 12 pregnancies no signs of foetal suffering were recorded, and all ended in live births, without complications, at the full term of pregnancy. The newborns had adequate somatometry at birth, and no congenital malformations occurred. The babies are now with middle age of 52 months (2 months - 7 years and six months), healthy and with normal growth; ten were breast fed.

Conclusion

Infliximab use wasn't associated with adverse effects, either to the foetus or the mother, in any of the 11 women that had pregnancies while on infliximab treatment and choose to proceed with gestation. Further prospective data collection of infliximab's effects in pregnancy will be useful to confirm its safety.