For those child bearing women on Methotrexate

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Methotrexate in Early Pregnancy May Not Cause Defects

Wed Dec 29,12:17 PM ET Health - Reuters

NEW YORK (Reuters Health) - Methotrexate is a potent drug that

induces abortion at high doses, and is used at low doses to treat

conditions like rheumatoid arthritis. There has been concern that

women taking low-dose methotrexate and don't realize they've become

pregnant could have babies with birth defects.

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Now comes word from French researchers that the risk does not seem to

be very great.

In a small study, Dr. Thierry Vial, of Center de Pharmacovigilance in

Lyon and colleagues examined the risk of major malformations of the

fetus among pregnant women who were treated with low-dose

methotrexate in early-stage pregnancy.

A total of 28 cases were included in the final analysis, published in

the Journal of Rheumatology.

Twenty-six of the women ended methotrexate treatment before 8 weeks

of gestation. Four patients had spontaneous abortions and five had

elective abortions.

Overall, there were a total of 19 live births. Of these, three were

premature. The full-term children all had birth weights within the

expected range, according to the investigators.

One child had minor anomalies, including a deformity of the feet and

an eyelid angioma. One premature infant had jaundice, and another

infant had transient respiratory distress and jaundice.

Methotrexate is an anti-folate drug, and this may be how it causes

adverse effects, Vial's team points out. They say it is therefore

especially important for women on methotrexate to heed the

recommendation for all women to take folate supplements before

pregnancy.

" This recommendation also applies to patients without preconception

folinic acid supplementation who have inadvertently continued

methotrexate after the beginning of pregnancy, " they write

SOURCE: Journal of Rheumatology, December 2004.