Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.
J Crohns Colitis. 2011 Apr;5(2):95-100. doi: 10.1016/j.crohns.2010.10.005. Epub 2010 Dec 9.
Recommendations on breastfeeding under thiopurines are inconsistent due to limited data.
To assess the risk of infections in offspring breastfed by mothers receiving azathioprine (AZA) for inflammatory bowel disease (IBD).
Babies, who were breastfed from their mothers treated either with or without AZA were included from a local pregnancy-registry. Women were asked by structured personal interview on general development, infections, hospitalisations and vaccinations of their offspring.
A group of 11 mothers taking AZA (median 150 mg/d) during pregnancy and lactation and another of 12 patients without using any immunosuppressive therapy breastfed 15 babies each for median 6 months and 8 months, respectively. Median age of children at time of interview was 3.3 and 4.7 years, respectively. All offspring showed age-appropriate mental and physical development. Infections were commonly seen childhood diseases. Similar rates were observed for most of the various infections between offspring with and without azathioprine exposure during breastfeeding. However, common cold more than two episodes/year and conjunctivitis were numerically more often reported in the group without AZA exposure. In an exploratory analysis no difference in the rate of hospitalisations was seen between exposed (0.06 hospitalisations/patient year) versus non-exposed children (0.12 hospitalisations/patient year, p=0.8)
Our study which reports the largest number of babies breastfed with exposure to AZA suggests that breastfeeding does not increase the risk of infections.
由于数据有限，关于硫唑嘌呤下母乳喂养的建议不一致。
评估接受硫唑嘌呤（AZA）治疗炎症性肠病（IBD）的母亲母乳喂养的婴儿感染的风险。
从当地妊娠登记处纳入了接受或不接受 AZA 治疗的母亲母乳喂养的婴儿。通过结构化个人访谈，询问女性关于其子女的一般发育、感染、住院和疫苗接种情况。
一组 11 名母亲在妊娠和哺乳期服用 AZA（中位数 150mg/d），另一组 12 名患者未使用任何免疫抑制疗法，分别母乳喂养了 15 名婴儿，中位数为 6 个月和 8 个月。访谈时儿童的中位数年龄分别为 3.3 岁和 4.7 岁。所有子女均表现出与年龄相适应的精神和身体发育。感染是常见的儿童疾病。在母乳喂养期间接受和未接受 AZA 暴露的婴儿中，大多数各种感染的发生率相似。然而，在未接受 AZA 暴露的组中，普通感冒的次数（每年超过 2 次）和结膜炎的次数较多。在探索性分析中，未观察到暴露组（0.06 次住院/患者年）与非暴露组（0.12 次住院/患者年，p=0.8）之间的住院率存在差异。
我们的研究报告了接受 AZA 暴露母乳喂养的婴儿数量最多，这表明母乳喂养不会增加感染的风险。
