The effects of azathioprine on birth outcomes in women with inflammatory bowel disease (IBD)

Lisa Shim, Guy D. Eslick, Alexander A. Simring, Henry Murray, Martin D. Weltman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


Aim: To investigate the effects of azathioprine/6-mercaptopurine (AZA/6-MP) on birth outcomes in women with inflammatory bowel disease (IBD). Methods: Details of pregnant women with IBD were obtained through an ObstetriX Database in 3 major teaching hospitals in Sydney from 1996 to 2006. Medical records were reviewed. Birth outcomes of interest were single live births, low birth weight (LBW) at term (< 2500. g), preterm births (< 37. weeks gestation), neonatal adverse outcomes, and congenital anomaly. Placental blood flow during third trimester of pregnancy was measured using arterial Doppler ultrasonography, where available. Results: All women had IBD diagnosed before pregnancy. 19 births were exposed to AZA/6-MP. 74 births that were never exposed to AZA/6-MP were selected as controls. Preterm birth was seen in 26.3% of the exposed group as compared to 13.5% of controls (p < 0.001). However, in univariate analysis, preterm birth was not associated with AZA/6-MP (OR=2.28; CI: 0.67-7.73). There was 1 neonatal adverse outcome in the exposed group as compared to 4 in controls (5.3% vs 5.4%, p = 0.97). One congenital anomaly was seen in each group (p = 0.27). No LBW at term was seen in either group. Placental blood flow in 4 women exposed to AZA/6-MP was normal. Conclusion: The use of AZA/6-MP during pregnancy in IBD women was not associated with an increased risk of preterm birth, LBW at term, neonatal adverse outcomes and congenital anomalies.

Original languageEnglish
Pages (from-to)234-238
Number of pages5
JournalJournal of Crohn's and Colitis
Issue number3
Publication statusPublished - Jun 2011
Externally publishedYes


  • Azathioprine
  • Birth outcome
  • Crohn's disease
  • Inflammatory bowel disease
  • Pregnancy


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