Optimum use of disease-modifying and immunosuppressive antirheumatic agents during pregnancy and lactation

Clinical Immunotherapeutics

Volumn 5, Issue 1, 1996, Pages 40-58

  Ramsey Goldman, Rosalind ^a   Schilling, Ellen ^a  

^a NORTHWESTERN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIRHEUMATIC AGENT; AZATHIOPRINE; BETAMETHASONE; CHLORAMBUCIL; CHLOROQUINE; CYCLOPHOSPHAMIDE; CYCLOSPORIN A; DEXAMETHASONE; GOLD; HYDROCORTISONE; HYDROXYCHLOROQUINE; IMMUNOSUPPRESSIVE AGENT; MERCAPTOPURINE; METHOTREXATE; METHYLPREDNISOLONE; PENICILLAMINE; PREDNISOLONE; PREDNISONE; SALAZOSULFAPYRIDINE; TRIAMCINOLONE;

ANIMAL EXPERIMENT; FEMALE; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; INTRAARTERIAL DRUG ADMINISTRATION; LACTATION; NONHUMAN; ORAL DRUG ADMINISTRATION; PREGNANCY; PRIORITY JOURNAL; REVIEW; RHEUMATIC DISEASE; RISK FACTOR;

EID: 0030043178     PISSN: 11727039     EISSN: None     Source Type: Journal    
DOI: 10.1007/BF03259314     Document Type: Review

References (180)

1. Briggs GG, Freeman RK, Yaffe SJ, editors. Drugs in pregnancy and lactation. Baltimore: Williams and Wilkins, 1989
2. Urowitz MB, Gladman DD, Farewell VT, et al. Lupus and pregnancy studies. Arthritis Rheum 1993; 36: 1392-7
3. Cecere PA, Persellin RH. The interaction of pregnancy and the rheumatic diseases. Clin Rheumatol 1981: 7: 747-68
4. Needs C, Brooks P. Drugs, pregnancy, and rheumatoid arthritis. In: Klippel JH, Dieppe PA. editors. Rheumatology. London: Mosby Year Book. 1994; 18: 4-6
5. Hazes JMW. Pregnancy and its effect on the risk of developing rheumatoid arthritis. Ann Rheum Dis 1991; 50: 71-4
6. Lockshin MD, Druzin ML. Rheumatic disease. In: Barren WM, Lindheimer MD, editors. Medical disorders during pregnancy. St Louis: Mosby Year Book, 1991; 366-99
7. Palit J, Clague RB. Wegener's granulomatous presenting during first trimester of pregnancy. BrJ Rheumatol 1990; 29: 389-90
8. Barren WB. Lindheimer MD, editors. Medical disorders during pregnancy. St Louis: Mosby Year Book, 1991
9. Corby DG. Aspirin in pregnancy: maternal and fetal effects. Pediatrics 1978; 62: 930-7
10. Brooks PM, Needs CJ. The use of antirheumatic medication during pregnancy and in the puerperium. Rheum Dis Clin North Am 1989; 15:789-806
11. Werler MM, Mitchell AA, ShapiroS. The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects. N Engl J Med 1989; 321: 1639-42
12. Barton JR, Sibal BM. Low-dose aspirin to improve perinatal outcome. Clin Obstet Gynecol 1991; 34: 251-61
13. Pritchard JA. Changes in blood volume during pregnancy and delivery. Anaesthesia 1965; 26: 293
14. Mendenhall HW. Serum protein concentrations in pregnancy. 1. Concentration in maternal serum. Am J Obstet Gynecol 1970; 106: 388
15. Dettli L, Spring P. The modifying effect of physiologic variables and disease upon pharmacokinelics. In: Pharmacology and the future of man. Proceedings of the Fifth International Congress on Pharmacology: San Francisco. 1992: Basel. Karger: 3: 165-73
16. The Nutrition Committee of the Canadian Pédiatrie Society and the Committee on Nutrition of the American Academy of Pediatrics. Breast feeding. Pediatrics 1978; 62: 591-601
17. Berlin CM. Pharmacological considerations of drug use in the lactating mother. Obstet Gynecol 1981: 58 Suppl.: 17-23
18. Maksymowych W. Russell AS. Antimalarials in rheumatology: efficacy and safety. Semin Arthritis Rheum 1987; 3: 206-21
19. Tett S, Cutler D, Day R. Antimalarials in rheumatic diseases. Balliere's Clin Rheumatol 1990: 4: 467-89
20. Fox RI, Kang H-I. Mechanism of action of antimalarial drugs: inhibition of antigen processing and presentation. Lupus 1993; 2 Suppl.: S9-S12
21. Fox R. Antimalarial drugs: mechanisms of action in autoimmune disease and prospects for drug development. Clin Immunother 1995; 4 (3): 219-34
22. Buchanan NMM, Toubi F. Khamashta MA. et al. The safety of hydroxychloroquine in lupus pregnancy: experience in 24 pregnancies. BrJ Rheumatol 1995; 35 Suppl. 1: 14
23. Dencker L, Lindquist NJ, Ullberg S. et al. Distribution of an 1-125 labelled chloroquin analogue in a pregnant macaca monkey. Toxicology 1975; 5: 255-64
24. Ullberg S, Lindquist NJ. Siostrand SE. Accumulation of chorioretinotoxic drugs in the foetal eye. Nature 1970; 227: 1257-8
25. Mgbodile MU. Effects of perinatal exposure of albino rats to chloroquin. Biol Neonate 1987: 51: 273-6
26. Campbell PM, Wilske K. In: Weaver AL, editor. Guidelines for reviewers of rheumatic disease care. 2nd ed. Atlanta: American College of Rheumatology, 1989
27. O'Day R. SAARDS-I. In: Klippel JH, Dieppe PA, editors. Rheumatology. London: Mosby Year Book, 1994; 12: 1-9
28. Akintonwa A. Placental and milk transfer of chloroquine in humans. Ther Drug Monit 1988; 10: 147-9
29. Neill WA, Panay GS, Duthie JJR, el al. Action of chloroquine phosphate in rheumatoid arthritis. II. chromosomal damaging effect. Ann Rheum Dis 1972; 32: 547-50
30. Wolfe MS, Cordero JF. Safety of chloroquine in chemosuppression of malaria during pregnancy. BMJ 1985; 290: 1466-7
31. Paufique L, Magnard P. Retinal degeneration in 2 children following preventive antimalarial treatment of mother during pregnancy. Bull Soc Ophthalmol Fr 1969; 69: 466-77
32. Parke AL. Antimalarial drugs, systemic lupus erythemalosus and pregnancy. J Rheumatol 1988; 15: 607-10
33. Hart CN, Naunton RF. The olotoxicity of chloroquine phosphate. Arch Otolaryngol Head Neck Surg 1964; 80: 407-12
34. Ross JB, Garatsos S. Absence of chloroquine-induced ototoxicity in a fetus. Arch Dermatol 1974; 109: 573
35. MacKenzie AH. Antimalarial drugs for rheumatoid arthritis (oral gold symposium). Am J Med 1983; 75: 48-58
36. Roubenoff R, Hoyt I, Pétri M, et al. Effects of antiinflammatorv and immunosuppressive drugs on pregnancy and fertility. Semin Arthritis Rheum 1988; 18: 88-110
37. The Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus. N Engl J Med 1991 ; 324: 150-4
38. Merland R, Creste M. Study of the elimination and estimation of nivaquine in human milk. Med Trop 1951 ; 11: 793
39. Nation RL, Hackett LP, Dusci LG, et al. Excretion of hydroxychloroquine in human milk. Br J Clin Pharmacol 1984: 17: 368-9
40. Ostensen M, Brown ND. Chiang PK, et al. Hydroxychloroquine in human breast milk. Eur J Clin Pharmacol 1985; 28: 357
41. AndersonPO. Drugs and breast feeding. Drug Intell Clin Pharm 1977: 11: 210-1
42. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics 1989: 84: 924-36
43. Tsokos GC. Immunomodulatory treatments in patients with rheumatic diseases: mechanism of action. Semin Arthritis Rheum 1987; 17: 24-38
44. Britton S. Palacios R. Cyclosporin A - usefulness, risks and mechanism of action. Immunol Rev 1982; 65: 5-22
45. Mason RJ, Thomson AW, Whiting PH. et al. Cyclosporineinduced fetotoxicity in the rat. Transplantation 1985; 39: 9-12
46. Brown PAJ, Gray ES, Whiting PH. et al. Effects of cyclosporin A on fetal development in the rat. Biol Neonale 1985; 48: 172-80
47. Tugwell P, Bombardier C.GeutM, et al. Low-dose cyclosporin versus placebo in patients with rheumatoid arthritis. Lancet 1990; 335: 1051-5
48. Yocum DE. Klippel JH, Wilder RL. et al. Cyclosporin A in severe, treatment refractory rheumatoid arthritis. Ann Inlern Med 1988; 109: 863-9
49. Kowal A, Carstens Jr.JH, Schnitzer TJ. Cyclosporine in rheumatoid arthritis. In: Fürst DE, Weinblatt ME, editors. Immunomodulators in the rheumatic diseases. New York: Marcel Dekker, 1990
50. Tokuda M, Kurata N. Mizoguchi A, et al. Effect of low-do.se cyclosporin A on systemic lupus erythematosus disease activity. Arthritis Rheum 1994; 37: 551-8
51. Lewis GJ, Larmont CAR, Lee HA, et al. Successful pregnancy in a renal transplant recipient taking cyclosporin A. BMJ 1983; 286: 603
52. Flechner SM, Katz AR, Rogers AJ, et al. The presence of cyclosporine in body tissues and fluids during pregnancy. Am J Kidney Dis 1985; 5: 60-3
53. Burrows DA, O'Neil TJ, Sorrells TL. Successful twin pregnancy after renal transplant maintained on cyclosporine A immunosuppression. Obstet Gynecol 1988; 72: 459-61
54. Lowenstein BR, Vain NW, Perrone SV, et al. Successful pregnancy after and vaginal delivery after heart transplantation. Am J Obstet Gynecol 1988; 158: 589-90
55. Ostensen M. Treatment with immunosuppressive and disease modifying drugs during pregnancy and lactation. Am J Reprod Immunol 1992; 28: 148-52
56. Cockburn I, Krupp P, Monka C. Present experience of Sandimmun in pregnancy. Transplant Proc 1989; 21: 3730-2
57. Pujals JM, Figueras G, Puig JM, et al. Osseous malformation in baby born to woman on cyclosporin. Lancet 1989; 1: 667
58. Hussein MM, Mooij JMV, Roujouleh H. Cyclosporine in the treatment of lupus nephritis including two patients treated during pregnancy. Clin Nephrol 1993; 40: 160-3
59. Calne RY, Brons IGM, Williams PF, et al. Successful pregnancy after paratropic segmental pancreas and kidney transplantation. BMJ 1988; 296: 1709
60. Baarsna R, Kamps WA. Immunological responses in an infant after cyclosporine A exposure during pregnancy. Eur J Pediatr 1993; 152:476-7
61. Product information. Sandimmune. Sandoz Pharmaceutical Corporation, 1991
62. Joyce DA. D-Penicillamine. Clin Rheumatol 1990; 4: 553-74
63. Keen CL, Mark-Savage P, Lormerdal BO, et al. Teratogenic effects of d-penicillamine in rats: relation to copper deficiency. Drug Nutr Interact 1983; 2: 17-34
64. Steffek AJ, Verussio AC, Watkins CA. Cleft palate in rodents after maternal treatment with lathyrogenic agents. Teratology 1972:5:33-8
65. Stivers FE, Steffek AJ, Yarington CT. Effect of lathyrogens on developing midfacial structures in the rat. J Surg Res 1971; 11:415-20
66. Harpey JP, Jandon MC, Clavel JP, et al. Cutis laxa and low serum zinc after antenatal exposure to d-penicillamine in rats. Lancet 1983; 2: 858
67. Steen VD, Blair S, Medsger TAJ. The toxicity of d-penicillamine in systemic sclerosis. Ann Intern Med 1986; 104: 699-705
68. Steen VD. When and how to use penicillamine for systemic sclerosis. J Musculoskeletal Med 1989; 4: 72-87
69. Lyle WH. Penicillamine in pregnancy. Lancet 1978; 1: 606-7
70. Mjolnerod OK, Rasmussen K, Dommerud SA, et al. Congenital connective-tissue defect probably due to d-penicillamine treatment in pregnancy. Lancet 1971; 1: 673-4
71. Solomon L, Abrams G, Dinner M, et al. Neonatal abnormalities associated with d-penicillamine treatment during pregnancy. N Engl J Med 1977; 296: 54-5
72. Gregory MC, Mansell MA. Pregnancy and cystinuria. Lancet 1983; 2: 1158-60
73. Paulus HE, Bulpitt KJ. Nonsteroidal antiinflammatory agents and corticosteroids. In: Schumacher HR, Klippel JH, Koopman WJ, editors. Primer on the rheumatic diseases. Atlanta: Arthritis Foundation, 1993: 298-303
74. Walker B. Induction of cleft palate in rats with antiinflammatory drugs. Teratology 1971; 4: 39-42
75. Pinsky L, DiGeorge AM. Cleft palate in the mouse: a teratogenic index of glucocorticoid potency. Science 1965; 147: 402-3
76. Walker BE. Induction of cleft palate in rabbits by several glucocorticoids. Proc Soc Exp Biol Med 1967; 125: 1281-4
77. Reinisch JM, Simon NG. Prenatal exposure to prednisone in humans and animals retards intrauterine growth. Science 1978; 202: 436-8
78. Pétri M. Systemic lupus erythematosus and pregnancy. Rheum Dis Clin North Am 1994; 20: 87-118
79. Blanford AT, Murphy BEP. In vitro metabolism of prednisone, dexamethasone, and cortisol by the human placenta. Am 3 Obstet Gynecol 1977; 127:264-7
80. Schardein JL. Chemically induced birth defects. New York: Marcel Dekker, 1985
81. Connolly ME. The pharmacologie management of systemic lupus erythematosus in pregnancy. Ann Intern Med 1981; 94: 671-2
82. Scott JR. Fetal growth retardation associated with maternal administration of immunosuppressives. Am J Obstet Gynecol 1977; 128:668-76
83. Kraus AM. Congenital cataract and maternal steroid injection. J Pediatr Ophthalmol Strabismus 1975; 12: 107-8
84. Cote CJ, Meuwissen HJ, Pickering RJ, et al. Effects on the neonate of prednisone and azathioprine administered to the mother during pregnancy. J Pediatr 1974; 85: 324-8
85. Cederqvist LL, Merkatz IR, Litwin SD, et al. Fetal immunoglobulin synthesis following maternal immunosuppression. Am J Obstet Gynecol 1977; 129: 687-90
86. Ramsey-Goldman R. Pregnancy in systemic lupus erythematosus. Rheum Dis Clin North Am 1988; 14: 169-85
87. Grigor RR, Shervington PC, Hughes GRV, et al. Outcome of pregnancy in systemic lupus erythematosus. Proc Soc Exp Biol Med 1977; 70: 99-100
88. Ost L, Wettrell G, Bjorkhem I, et al. Prednisolone excretion in human milk. J Pediatr 1985; 106: 1008-111
89. Szabo KT, Difebb ME, Phelan DG. The effect of gold containing compounds on pregnant rabbits and their fetuses. Vet Pathol 1978; 15:95-8
90. Anonymous. Drugs for rheumatoid arthritis. Med Lett Drugs Ther 1994; 36: 101-6
91. Richards AJ. Transfer of gold from mother to foetus. Lancet 1977; 1:99
92. Rocker I, Hendeson MJH. Transfer of gold from mother to foetus. Lancet 1976; 2: 1246
93. Miyamoto T, Miyaji S, Horiuchi T, et al. Gold therapy in bronchial asthma: special emphasis upon blood levels of gold and its teratogenicity. Nippon Naika Gakkai Zasshi 1974; 63: 190-7
94. Tozman ECS, Gottlieb NL. Adverse reactions with oral and parenteral gold preparations. Med Toxicol Adverse Drug Exper 1987; 2: 177-89
95. Blau SP. Metabolism of gold during lactation. Arthritis Rheum 1973; 16:777-8
96. Xiong JM, Liang B, Mo YQ, et al. Tératologie studies of methyl 5-aminosalicylate and salicylazopyridine. Acta Pharmacol Sin 1992; 13: 265-7
97. Folb PI, Graham Dukes MN, editors. Drug safety in pregnancy. Amsterdam: Elsevier, 1990
98. Jarnerot G, Into-Malmberg MB, Esbjorner E. Placental transfer of sulphasalazine and sulphapyridine and some of its metabolites. Scand J Gastroenterol 1981; 16: 693-7
99. Mogadam M, Dobbins WOIII, Korelitz BI, et al. Pregnancy in IBD: effect of sulphasalazine and corticosteroids on fetal outcome. Gastroenterology 1981; 80: 72-6
100. Craxi A, Pagliarello F. Possible embryotoxicity of sulfasalazine (letter]. Arch Intern Med 1980; 140: 1674
101. Hoo JJ, Hadro TA, von Behren P. Possible teratogenicity of sulfasalazine. N EnglJMed 1988:318: 1128
102. Newman NM, Correy JF. Possible teratogenicity of sulphasalazine.MedJ Aust 1983; 1:528-9
103. Levi S. Liberman M, Levi AJ, et al. Reversible congenital neutropenia associated with maternal sulphasalazine therapy (letter]. Eur J Pediatr 1988; 148: 174-5
104. Branski D. Kerem E, Gross-Kieselstein E, et al. Bloody diarrhea - a possible complication of sulphasalazine transferred through human breast milk. J Pediatr Gastroenterol Nutr 1986; 5:316-7
105. McKendry RJR. Purine analogs. In: Dixon JS, Fürst DE. editors. Second line agents in the treatment of rheumatic diseases. New York: Marcel Dekker, 1991
106. Clements PJ. Cytotoxic immunosuppressive drugs. In: Paulus HE. Fürst DE. Dromgooles H, editors. Drugs for rheumatic disease. New York: Marcel Dekker, 1987: 135-6
107. Fürst DE. Clements PJ. SAARDs-II. In: Klippel JH, Dieppe PE. editors. Rheumatology. London: Mosby Year Book, 1994; 13: 1-7
108. Githens JH, Rosencrantz JG, Tunnock SM, et al. Teratogenic effects of azathioprine (Imuran). J Pediatr 1965; 66: 962-3
109. Fujii TM, Kowa Y. Teratogenesis of azathioprine (Imuran) in mice and rats. Oyo Yakuri 1968; 2: 401
110. Tuchmann-Duplessis H, Mercier-Parot L. Production in rabbits of malformations of the extremities by administration of azathioprine and 6-mercaptopurine. C R Seances Soc Biol Fil 1966; 160:501-6
111. Davison JM, Dellagrammatikas H, Parkin JM, et al. Maternal azathioprine therapy and depressed haematopoiesis in the babies of renal allograft patients. Br J Obstet Gynaecol 1985; 92: 233-9
112. Rudolph JE, Schweizer RT. Bartkus SA. Pregnancy in renal transplant patients. Transplantation 1979; 27: 26-9
113. The Registration Committee of the European Dialysis and Transplant Association. Successful pregnancies in women treated by dialysis and kidney transplantation. Br J Obstet Gynaecol 1980; 87: 839-45
114. Felson DT, Anderson J. Evidence for the superiority of immunosuppressive drugs and prednisone over prednisone alone in lupus nephritis. Results of a pooled analysis. N Engl J Med 1984:311: 1528-33
115. Leb DE, Weisskopf B, Kanovitz BS. Chromosome aberrations in the child of a kidney transplant recipient. Arch Intern Med 1971; 128:441-4
116. Marushak A, Weber T, Bock J, et al. Pregnancy following kidney transplantation. Acta Obstet Gynecol Scand 1986: 65: 557-9
117. Davison JM, Lindheimer MD. Pregnancy in renal transplant recipients. J Reprod Med 1982; 27: 613-21
118. Williamson RA, Karp LE. Azathioprine teratogenicity: review of the literature and case report. Obstet Gynecol 1981: 58: 247-50
119. Nishimura H, Tanimura T. Clinical aspects of the teratogenicity of drugs. New York: American Elsevier, 1976
120. Burleson RL, Sunderji SG, Aubry RH, et al. Renal allotransplantation during pregnancy: successful outcome for mother, child, and kidney. Transplantation 1983; 36: 334
121. Ogburn PLJ. Kitzmiller JL, Hare J W, et al. Pregnancy following renal transplantation in class T diabetes mellitus. JAMA 1986; 255: 911-5
122. DeWitte DB. Buick MK, Cyran SE, et al. Neonatal pancytopenia and severe combined immunodeficiency associated with antenatal administration of azathioprine and prednisone. J Pediatr 1984: 105:625-8
123. Haagsma EB, Visser GH, Klompmaker IJ, et al. Successful pregnancy after orthotropic transplantation. Obstet Gynecol 1989: 74: 442-3
124. Coulam CB, Moyer TP. Jiang NS, et al. Breast-feeding after renal transplantation. Transplant Proc 1982; 14: 605-9
125. Cannon GW. Ward JR. Cytotoxic drugs and sulfasalazine. In: McCarty D. editor. Arthritis and allied conditions. 2nd ed. Philadelphia: Lea and Febiger, 1989
126. Klinenberg JR. Reichman R, Clements PJ. Investigational therapy for rheumatoid arthritis. In: Progress in clinical immunology, vol. I. New York: Grune and Stratton, 1984
127. Lawler SD, Lele KP. Chromosomal damage induced by chlorambucil and chronic lymphocytic leukemia. Scand J Haematol 1972: 17: 197-204
128. Westin J. Chromosome abnormalities after chlorambucil therapy of polycythemia vera. Scand J Haematol 1976; 17: 197-204
129. Clements PJ. Alkylating agents. In: Dixon JS, Fürst DE, editors. Second line agents in the treatment of rheumatic diseases. New York: Marcel Dekker. 1991
130. Kahn MF, Ariel J, Bloch-Michel H, et al. Leucémies aiguës apres traitement par agents cytotoxiques en rheumatologies: 19 observations chez 2006 patients. Nouv Presse Med 1979; 8: 1393-7
131. Monie IW. Chlorambucil-induced abnormalities of urogenital system of rat fetuses. Anat Rec 1961; 139: 145
132. Takacs SE. Warkany J. Chromosome changes in embryos treated with various teratogens. J Embryol Exp Morphol 1967; 18: 215-26
133. Brummett ES, Johnson EM. Morphological alterations in the developing fetal rat limb due to maternal injection of chlorambucil. Teratology 1979; 20: 279-88
134. Chapman RM, Sutcliffe SB. Protection of ovarian function by oral contraceptives in women receiving chemotherapy for Hodgkin's disease. Blood 1981:58: 849-51
135. Glode LM. Robinson J, Could SF. Protection from cyclophosphamide-induced testicular damage with an analogue of gonadotropin releasing hormone. Lancet 1981; I: 1132-4
136. Ataya KM, McKanna JA, Weintraub AM, et al. A luteinizing hormone-releasing hormone agonist for the prevention of chemotherapy-induced ovarian follicular loss in rats. Cancer Treat Rev 1985:45: 3651-6
137. Nseyo UO. Hüben RP. Klioze SS, et al. Protection of germinal epithelium with luteinizing hormone-releasing hormone analogue. J Urol 1985; 34: 187-90
138. Sokal JE, Lessmann EM. Effects of cancer chemotherapeutic agents on the human fetus. JAMA 1960; 172: 1765-71
139. Shotton D, Monie IW. Possible teratogenic effect of chlorambucil on a human fetus. JAMA 1963; 186: 74-5
140. Steege JF, Caldwell DS. Renal agenesis after first trimester exposure to chlorambucil. South Med J 1980; 73: 1414-5
141. Thompson J. Conklin KA. Anesthetic management of a pregnant patient with scleroderma. Anaesthesiology 1983: 59: 6971
142. Austin HA. Klippel JH. Balow JE, et al. Therapy of lupus nephritis: controlled trial of prednisone and cytotoxic drugs. N Engl J Med 1986: 314: 614-9
143. Hackenbergerl. KreybigT. Vergleichende teratologische Untersuchungen bei der maus und der ratte. Arzneimittel Forschung 1965; 15: 1456-60
144. Chauhe S. Kury G. Murphy ML, et al. Teratogenic effects of cyclophosphamide in the rat. Cancer Chemother Biol Response Modif 1967:51: 363-76
145. Gerlinger P, Clavert J. Anomalies observées chez des lapins issus de mères traitées au cyclophosphamide. C R Seances SocBiolFil 1965; 159: 1462-6
146. Fritz H, Hess R. Effects of cyclophosphamide on embryonic development in the rabbit. Agents Actions 1971; 2: 83-6
147. Wilk A, McClure HM, Horigan EA, et al. Induction ofcraniofacial malformations in the rhesus monkey with cyclophosphamide. Teratology 1978; 17: 24A
148. Koyama H, Wada T, Nishizawa Y. Induced ovarian failure and its therapeutic significance in patients with breast cancer. Cancer 1977; 39: 1403-9
149. Boumpas DT, Austin HA III, Vaughn EM, et al. Risk of sustained amenorrhea in patients with systemic lupus erythematosus receiving intermittent pulse cyclophosphamide therapy. Ann Intern Med 1993; 119: 366-9
150. Nicholson HO. Cytotoxic drugs in pregnancy: review of reported cases. J Obstet Gynaecol 1968; 75: 307-12
151. Kirshon B, Wasserstrum N, Willis R, et al. Teratogenic effects of first-trimester cyclophosphamide therapy. Obstet Gynecol 1988; 72: 462-4
152. Pizzuto J, Aviles A, Noriega L, et al. Treatment of acute leukemia during pregnancy: presentation of nine cases. Cancer Treat Rep 1980; 64: 679-83
153. Greenberg LH, Tanaka KR. Congenital anomalies probably induced by cyclophosphamide. JAMA 1964; 188: 423-6
154. Toledo TM, Harper RC, Moser RH. Fetal effects during cyclophosphamide and irradiation therapy. Ann Intern Med 1971 ; 74: 87-91
155. Coates A. Cyclophosphamide in pregnancy. Aust J Obstet Gynaecol 1970; 10: 33-4
156. Murray CL, Reichert JA, Anderson J, et al. Multimodal cancer therapy for breast cancer in the first trimester of pregnancy. JAMA 1984; 252: 2607-8
157. Sweet DL, Kinzie J. Consequences of radiotherapy and antineoplastic therapy for the fetus. J Reprod Med 1976; 17: 241-6
158. Wiernik PH, Duncan JH. Cyclophosphamide in human milk. Lancet 1971; 1:912
159. Mullarkey MF, Blumenstein BA, Andrade P, et al. Methotrexate in the treatment of corticosteroid-dependent asthma. N Engl JMed 1988:318:603-7
160. Songstridey N, Fürst DE. Methotrexate - the rapidly acting drug. Clin Rheumatol 1990; 4: 575-94
161. Rothenberg RJ, Graziano FM, Grandone JT, et al. The use of methotrexate in steroid-resistant SLE. Arthritis Rheum 1988; 31:612-5
162. DePaola DP, Mandella RD. Folate deficiency and in vitro palatogenesis II: effects of methotrexate on rabbit palate fusion, folate pools, and dihydrofolate reductase activity. J Craniofac Genet Dev Biol 1984; 4: 321-7
163. Zamenhof S. Differential effects of antifolate on the development of brain parts in chick embryos. Growth 1985; 49: 28-33
164. Skalko RG, Gold MR Teratogenicity of methotrexate in mice. Teratology 1974; 9: 159-64
165. Schmid BP. Monitoring of organ formation in rat embryos after in vitro exposure to azathioprine, mercaptopurine, methotrexate, or cyclosporine A. Toxicology 1984; 31:9-21
166. Adams CE, Hay M, Lutwak-Mann C, et al. The actions of various agents on the rabbit embryo. J Embryol Exper Morphol 1961:9:468-91
167. Wilson JG, Scott WJ, Ritter EJ, et al. Comparative distribution and embryotoxicity of methotrexate in pregnant rats and Rhesus monkeys. Teratology 1979; 19: 71-80
168. Groenendal H, Rampen FH. Methotrexate and trimethoprimsulphamethoxazole - a potentially hazardous combination. Clin Exp Dermatol 1990; 15: 358-60
169. Bower C, Stanley FJ. Dietary folate as a risk factor for neuraltube defects: evidence from a case-control study in Western Australia. Med J Aust 1989; 150: 613-9
170. Milunsky A, Jick H, Jick SS. Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 1989; 262: 2847-52
171. Kremer JM, Alarcon OS, Lightfoot RW, et al. Methotrexate for rheumatoid arthritis: suggested guidelines for monitoring liver toxicity. Arthritis Rheum 1994; 37: 316-28
172. Chotiner HC. Nonsurgical management of ectopic pregnancy associated with severe hyperstimulation syndrome. Obstet Gynecol 1985; 66: 740-3
173. Oyer R. Treatment of cervical pregnancy with methotrexate. Obstet Gynecol 1988; 71: 469-71
174. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. Baltimore: Williams and Wilkins, 1986
175. Kozlowski RD, Steinbrunner JV, MacKenzie AH, et al. Outcome of first-trimester exposure to low-dose methotrexate in eight patients with rheumatic disease. Am J Med 1990; 88: 589-92
176. Waiden PAM, Bagshawe KD. Pregnancies after chemotherapy for gestational trophoblastic tumours. Lancet 1979; 2: 1241
177. Turchi JJ, Villasis C. Anthracyclines in the treatment of malignancy in pregnancy. Cancer 1988; 61: 435-40
178. Barnes AB, Link DA. Childhood dermatomyositis and pregnancy. Am J Obstet Gynecol 1983; 146: 335-6
179. Sivanesaratnam V, Sen DK. Normal pregnancy after successful treatment of choriocarcinoma with cerebral métastases: a case report. J Reprod Med 1988; 33: 402-3
180. Schleuning M, Clemm C. Chromosomal aberrations in a newborn whose mother received cytotoxic treatment during pregnancy. N Engl J Med 1987; 317: 1666-7