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MotherToBaby

Medications and More during pregnancy and breastfeeding

Methotrexate

Selected References:

  • American College of Obstetricians and Gynecologists. 2018. Tubal ectopic pregnancy. ACOG Practice Bulletin No. 193. Obstet Gynecol 131:e9—e103.  
  • Del Campo M, et al. 1999. Developmental delay in fetal aminopterin/methotrexate syndrome. Teratology 60:10-12.  
  • Donnenfield AE, et al. 1994. Methotrexate exposure prior to and during pregnancy. Teratology 49:79-81.  
  • Eck, LK, et al. 2017. Risk of adverse pregnancy outcome after paternal exposure to methotrexate within 90 days before pregnancy. Obstet Gynecol 129(4):707-714.  
  • Ersoy GS, et al. 2016. Comparison of the long-term effects of single-dose methotrexate and salpingectomy on ovarian reserve in terms of anti-müllerian hormone levels. Human Fertility 19(4):262-267. 
  • Feldkamp M, Carey JC. 1993. Clinical teratology counseling and consultation case report: low dose methotrexate exposure in the early weeks of pregnancy. Teratology; 47:533-439.  
  • French AE, et al. 2003. Effect of methotrexate on male fertility. Can Fam Physician 49:577-578.  
  • Friedman S, et al. 2017. Paternal use of azathioprine/6-mercaptopurine or methotrexate within 3 months before conception and long-term health outcomes in the offspring-A nationwide cohort study. Reprod Toxicol 73:196-200.  
  • Gubatan J, et al. 2023. Paternal medications in inflammatory bowel disease and male fertility and reproductive outcomes: A systematic review and meta-analysis. Clin Gastroenterol Hepatol. 21(9):2222-2238. 
  • Hoeltzenbein M, et al. 2008. Paternal exposure to drugs—is there an increased risk for congenital abnormalities? Experience of the Berlin Institute for Clinical Teratology and Drug Risk Assessment during Pregnancy. Reprod Toxicol 26: 64 [abstract].  
  • Hyoun SC, et al. 2012. Teratogen update: methotrexate. Birth Defects Res A Clin Mol Teratol, 94(4):187-207. 
  • Jordan RL, et al. 1976. Embryotoxicity of the folate antagonist methotrexate in rats and rabbits. Teratology 15:73-80.  
  • Kozlowski RD, et al. 1990. Outcome of first-trimester to low-dose methotrexate in eight patients with rheumatic disease. Am J Med 88(6):589-592.  
  • Lee CY, et al. 2010. A pilot study of paternal drug exposure: the Motherisk experience. Reprod Toxicol. 29(3):353-60.  
  • Lloyd ME, et al. 1999. The effects of methotrexate on pregnancy, fertility and lactation. Q J Med 92:551-563  
  • Martin M.C., et al. 2014. Methotrexate embryopathy after exposure to low weekly doses in early pregnancy. Reprod Toxicol, 43:  26-29. 
  • Martínez Lopez JA, et al. 2009. Systematic review on the safety of methotrexate in rheumatoid arthritis regarding the reproductive system (fertility, pregnancy and breastfeeding). Clin Exp Rheumatol 27:678-684.  
  • McLaren JF, et al. 2009. Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation. Fertil Steril 92(2):515-519.  
  • Methorexate Drug Label, 2020: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/040054s015,s016,s017.pdf.   
  • Nagafuchi H, et al. 2022. Pregnancy outcomes in patients with rheumatoid arthritis who discontinue methotrexate treatment to conceive. Clin Rheumatol; 41(3):669-675. 
  • Ostensen M, et al. 2009. Management of RA medications in pregnant patients. Nat Rev Rheumatol 5(7):382-390. 
  • Wentzell N, et al. 2023. Use of methotrexate in girls and women of childbearing age, occurrence of methotrexate-exposed pregnancies and their outcomes in Germany: A Claims Data Analysis. Clin Drug Investig. 43(2):109-117. 
  • Zanetti A, et al. 2022. Impact of rheumatoid arthritis and methotrexate on pregnancy outcomes: retrospective cohort study of the Italian Society for Rheumatology. RMD Open; 8(2):e002412. 
  • Zarén P, et al. 2023. Methotrexate use among men-association with fertility and the perinatal health of their children: a Swedish nationwide register study. Fertil Steril. 120(3 Pt 2):661-669. 

 

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