{'fraction_non_alphanumeric': 0.029623360135421075, 'fraction_numerical': 0.00973338975878121, 'mean_word_length': 5.423913043478261, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Pregnancy during adalimumab use for psoriasis

Editor As more biological medications become available to treat psoriasis, the number of women who conceive during treatment will increase. When evaluating medications in women who become pregnant, it is important for dermatologists to accurately address the complications for the child. We report a 34-year-old woman who inadvertently became pregnant during adalimumab therapy, despite the fact that she had been counselled about using contraception. She received adalimumab for psoriasis with excellent response for 3 months prior to conception and during 5 weeks of gestation. Amniocentesis failed to detect any anomaly. The patient had an elective caesarean section performed at 38.5 weeks, and a low-birth-weight newborn was delivered. The child has normal development at 12 months follow-up. Data regarding the use of anti-TNF therapy during pregnancy come from rheumatology and gastroenterology. Most reports regard women with Crohn’s disease (CD) or rheumatic disease [reumatoid arthritis (RA), psoriatic arthritis, spondylarthritis (SpA), juvenile idiopathic arthritis (JIA)], and suggest that infliximab or etanercept treatment during the first trimester does not lead to an increased rate of birth defects, miscarriages or preterm delivery. In 23 women with rheumatic diseases exposed to anti-TNF-a (etanercept, infliximab, adalimumab) during first trimester, there were 6 spontaneous miscarriages (26%), 3 elective terminations and 14 live births. Of note, there was an increased risk for preterm delivery and lower birth weight in women with RA, regardless of medication. There are few reports of anti-TNF-a continued throughout pregnancy. In 10 women with CD who received infliximab throughout pregnancy, all had live births, with three premature deliveries and one low-birth-weight infant, with no congenital malformations. Women with rheumatic disease were exposed to infliximab or etanercept throughout pregnancy with no complications. There are 10 reported pregnancies with adalimumab use (Table 1). The molecular structure of adalimumab (IgG1 monoclonal antibody) seems to permit little placental transfer during the first trimester, but placental transfer cannot be excluded during the second or third trimester. So, the groups of women exposed to anti-TNF at the beginning of the first trimester