The only thing that made me weary here was having a baby on immunosuppressants, and the danger that could present for the fetus. Anyone knows if this can affect the baby on the long term (associated with premature birth)?
During pregnancy the mother was on a triple immunosuppressant regimen: azathioprine, tacrolimus, and prednisolone (corticosteroid). The first is a Pregnancy Class D drug (some reports of human birth defects), and the two are class C (birth defects only in animal studies)
A study on azathioprine use in early pregnancy found an increased risk of congenital malformations which wasn't statistically significant (from 4.7% to 6.2%) , and an association with preterm birth and low-weight[1].
But a later meta-analysis concluded only the increased risk of preterm birth was significant for this class of drugs[2]
It's mentioned in the article that the mother developed pre-eclampsia (simply put, hypertension during pregnancy, which can lead to eclampsia, with seizures and coma). This should also be a concern for the other women in the study[3]:
Firstly, immunosuppressants might increase pre-eclampsia, since the risk is about double in women with a kidney transplant (22%).
Also, the age of the donated uterus should be considered: the risk increases seven-fold for pregnancies after 50, though it hasn't been shown the problem is in the uterus itself.
Finally, the risk is higher for IVF conception.
Given this accumulation of risk, I'm curious how the other pregnancies carry on.To understand what's at risk, being born preterm is associated with increased morbidity and mortality, as well as lower achievement in general. Some papers point towards epigenetic changes (DNA methylation) as the etiology.
