TY - JOUR
T1 - Fetal methotrexate syndrome: A systematic review of case reports
AU - Verberne, Eline A.
AU - de Haan, Emma
AU - van Tintelen, J. Peter
AU - Lindhout, Dick
AU - van Haelst, Mieke M.
N1 - Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Methotrexate is a folic acid antagonist known to be teratogenic in humans. Several cases of congenital malformations after fetal exposure to methotrexate have been published, resulting in the establishment of the ‘fetal methotrexate syndrome’. However, it is unclear which congenital anomalies can truly be attributed to methotrexate exposure. The objective of this review is to delineate a consistent phenotype of the fetal methotrexate syndrome. We performed a systematic review that yielded 29 cases of (congenital) anomalies after in utero exposure to methotrexate and compared their malformation pattern to that of children and fetuses with congenital anomalies in general. Statistically significant higher proportions of microcephaly, craniosynostosis, tetralogy of Fallot, pulmonary valve atresia, limb reduction defects and syndactyly were found in the methotrexate group, indicating that these congenital anomalies are truly part of the fetal methotrexate syndrome. These results aid clinicians with diagnosing fetal methotrexate syndrome.
AB - Methotrexate is a folic acid antagonist known to be teratogenic in humans. Several cases of congenital malformations after fetal exposure to methotrexate have been published, resulting in the establishment of the ‘fetal methotrexate syndrome’. However, it is unclear which congenital anomalies can truly be attributed to methotrexate exposure. The objective of this review is to delineate a consistent phenotype of the fetal methotrexate syndrome. We performed a systematic review that yielded 29 cases of (congenital) anomalies after in utero exposure to methotrexate and compared their malformation pattern to that of children and fetuses with congenital anomalies in general. Statistically significant higher proportions of microcephaly, craniosynostosis, tetralogy of Fallot, pulmonary valve atresia, limb reduction defects and syndactyly were found in the methotrexate group, indicating that these congenital anomalies are truly part of the fetal methotrexate syndrome. These results aid clinicians with diagnosing fetal methotrexate syndrome.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067288100&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31181251
U2 - https://doi.org/10.1016/j.reprotox.2019.05.066
DO - https://doi.org/10.1016/j.reprotox.2019.05.066
M3 - Review article
C2 - 31181251
SN - 0890-6238
VL - 87
SP - 125
EP - 139
JO - Reproductive Toxicology
JF - Reproductive Toxicology
ER -