Safety evaluation of the use of calcineurin inhibitor to prenatal and postpartum women in Japan from a health administrative database

K Yashima; A Noda; T Ishikawa; F Matsuzaki; K Miyakoda; H Nishigori; N Mano; T Obara

doi:10.3233/NPM-230138

Safety evaluation of the use of calcineurin inhibitor to prenatal and postpartum women in Japan from a health administrative database

J Neonatal Perinatal Med. 2023;16(3):461-473. doi: 10.3233/NPM-230138.

Authors

K Yashima¹, A Noda^{2

3

4}, T Ishikawa⁵, F Matsuzaki^{3

4}, K Miyakoda⁶, H Nishigori⁷, N Mano^{2

5}, T Obara^{2

3

4}

Affiliations

¹ Department of Pharmacy, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Sendai, Japan.
² Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.
³ Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁴ Division of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
⁵ Laboratory of Biomolecule and Pathophysiological Chemistry, Graduate School of Medicine, Tohoku University, Sendai, Japan.
⁶ Clinical & Translational Research Center, Kobe University Hospital, Kobe, Japan.
⁷ Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan.

PMID: 37742666
DOI: 10.3233/NPM-230138

Abstract

Background: To investigate the use of calcineurin inhibitors (CNIs) in pregnant Japanese women and to evaluate their safety in infants.

Methods: Data were extracted from the claims database of the Japan Medical Data Center. The prevalence of CNIs was evaluated 180 days before pregnancy onset, during pregnancy, and within180-days post partum. We investigated the characteristics of the infants, including the presence of major malformations and their diagnoses, for 1 year after birth.

Results: A total of 91,865 pregnancies in 80,049 women were included. Fifty-three women were prescribed CNIs between 180-day before pregnancy onset and 180-day postpartum; 35 of the 53 women were prescribed the drugs during pregnancy, and 10 of their infants were born preterm. Three were diagnosed with major congenital malformations, such as patent ductus arteriosus. Six preterm infants presented with infant respiratory distress syndrome.

Conclusions: No congenital anomalies were clearly attributable to the use of CNIs during pregnancy.

Keywords: Claim database; cyclosporin; infant; pregnancy; tacrolimus.