Department of Ophthalmology, Farabi Eye Hospital Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, South Karegar street, Tehran, Iran.
Maternal, Fetal, and Neonatal Research Center, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int Ophthalmol. 2021 Feb;41(2):743-751. doi: 10.1007/s10792-020-01610-2. Epub 2020 Oct 12.
Anti-vascular endothelial growth factor (VEGF) medications are widely used for treatment of a number of vitreoretinal disorders. However, the evidence for their effect on fetal and maternal health during pregnancy is very limited. The goal of this article is to accumulate evidence for the indications of anti-VEGF medications during pregnancy and their effects on maternal and fetal health.
Review of literature regarding anti-VEGF administration during pregnancy and using PubMed database without language or date limit.
The main indications for treatment with intravitreal anti-VEGF medications include choroidal neovascularization (CNV) followed by retinal vascular occlusion (RVO) and complications of diabetes such as neovascular glaucoma, diabetic retinopathy (DR) and diabetic macular edema (DME). Among anti-VEGF medications, only ranibizumab and bevacizumab have been used during pregnancy with latter by far more than the former.
Women of childbearing age should be consulted regarding the potential adverse effects of anti-VEGF medications on fetal health and the risk of early pregnancy loss. They should be strongly encouraged to use appropriate contraceptive methods during treatment. A timely obstetrics consultation may help in this situation. Attempt for pregnancy should be withheld for at least 3 months following last injection of ranibizumab and aflibercept, and for at least 6 months following last injection of bevacizumab.
抗血管内皮生长因子（VEGF）药物被广泛用于治疗多种玻璃体视网膜疾病。然而，关于其在怀孕期间对胎儿和母亲健康影响的证据非常有限。本文的目的是积累怀孕期间使用抗 VEGF 药物的适应证及其对母婴健康影响的证据。
对怀孕期间使用抗 VEGF 药物的文献进行综述，并使用无语言或日期限制的 PubMed 数据库进行检索。
治疗脉络膜新生血管（CNV）、视网膜血管阻塞（RVO）和糖尿病并发症（如新生血管性青光眼、糖尿病视网膜病变（DR）和糖尿病黄斑水肿（DME））的主要适应证是使用玻璃体内抗 VEGF 药物。在抗 VEGF 药物中，只有雷珠单抗和贝伐珠单抗在怀孕期间使用过，而后者的使用远远超过前者。
应告知有生育能力的妇女抗 VEGF 药物对胎儿健康的潜在不良影响以及早期妊娠丢失的风险。应强烈鼓励她们在治疗期间使用适当的避孕方法。在最后一次注射雷珠单抗和阿柏西普后至少 3 个月，以及最后一次注射贝伐珠单抗后至少 6 个月内应避免怀孕。
