Perinatal Outcomes in Women Exposed to Monoclonal Antibody Biologics During Pregnancy

Objective: Biologics, often known as monoclonal antibody biologics (mAbs), have improved the treatment and quality of life for many patients with inflammatory and autoimmune diseases. Disease remission is the strongest predictor of perinatal outcomes in pregnancies exposed to monoclonal antibodies. The aim of this study was to evaluate maternal and perinatal outcomes in pregnancies receiving mAbs therapy. Materials and Methods: We retrospectively reviewed 21 singleton pregnancies. Drug exposure during pregnancy was classified as: exposure throughout all trimesters, discontinuation in the first trimester, or discontinuation in the third trimester. mAbs drugs were classified into three groups based on their mechanism:Anti-TNF α, anti-cytokine, and anti-B cell agents. Results: The most common underlying disease was Familial Mediterranean Fever. Certolizumab pegol and Anakinra were the most frequently administered anti-TNF α and anti-cytokine agents, respectively. The mean gestational age at delivery was 38±1.2 weeks, and the mean birth weight was 3083±416 g. Rates of fetal growth restriction, preterm birth, and neonatal intensive care unit admission were significantly higher in patients with multiple autoimmune or inflammatory diseases compared with patients without such conditions (p < 0.05). Conclusion: This study demonstrated that the coexistence of multiple autoimmune or inflammatory diseases may be significantly associated with a higher incidence of adverse obstetric outcomes in pregnancy.