The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort

• Published in: Neurology Vol. 65; no. 6; p. 807
• Main Authors: Boskovic, R, Wide, R, Wolpin, J, Bauer, D J, Koren, G
• Format: Journal Article
• Language: English
• Published: United States 27.09.2005
• Subjects: Abnormalities, Drug-Induced - epidemiology; Abortion, Spontaneous - chemically induced; Abortion, Spontaneous - epidemiology; Adult; Cohort Studies; Female; Fetal Death - chemically induced; Fetal Death - epidemiology; Humans; Immunologic Factors - adverse effects; Infant, Low Birth Weight; Infant, Newborn; Interferon beta-1a; Interferon beta-1b; Interferon-beta - adverse effects; Longitudinal Studies; Multiple Sclerosis - drug therapy; Pregnancy; Prenatal Exposure Delayed Effects - chemically induced; Prenatal Exposure Delayed Effects - epidemiology; Prospective Studies; Risk Factors
• ISSN: 1526-632X
• DOI: 10.1212/01.wnl.0000180575.77021.c4

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.