Colchicine Is Safe For Pregnant Women

A new report coming out of Israel states that the common treatment for gout, colchicine, is safe to use during pregnancy.

Mediterranean Fever

Colchicine isn't just a gout drug, however. The anti-inflammatory drug has been in use for decades for the prevention and treatment of familial Mediterranean fever. This genetic condition is rare and tends to strike those of Jewish, Arabic, Armenian, and Turkish ancestry, said Dr. Asher Ornoy and colleagues from Jerusalem's Hebrew University Hadassah Medical School explain.

Mediterranean fever causes periodic bouts of fever and inflammation and can increase the risk for miscarriage and early delivery in pregnant women. But treatment with colchicine can help a woman with the condition have a successful pregnancy outcome.

Birth Defects

Since colchicine is known to cross the placenta and there has been an association between the drug and birth defects in certain animal studies, experts worried that the medication may be dangerous to the fetus. There was a specific concern that colchicine might affect cell division, noted Ornoy and his research team.

While human studies of colchicine have been reassuring on this score, the studies to date were small and were performed without control groups, said the report published in the American Journal of Obstetrics & Gynecology.

In order to determine the safety of colchicine in pregnant women, the scientists studied 238 women who had been treated with the drug during their pregnancies. As a control group, the team also studied 964 women who had not taken colchicine or any other drugs with the potential for harm during their pregnancies.

Of the women in the colchicine group, 97% of them had used the drug during their first trimesters of pregnancy, while 80% used colchicine for the duration of their pregnancies. Almost 90% of the women were taking the medication for familial Mediterranean fever, 8% took it for Behçet disease—an autoimmune disease common to those of Mediterranean descent—and the remainder took colchicine for other reasons. Less than 1% of the women made use of the drug for treating gout. 

From the colchicine group, 4.7% of the babies had major congenital birth defects, for instance heart malformations. This is as compared to 3.2% of the babies born to the women in the control group. The difference between these figures is not considered statistically significant. None of the babies from mothers taking colchicine had chromosomal defects like Down syndrome, for instance.

The babies born to mothers in the colchicine group were delivered at 39 weeks in comparison with 40 weeks for the babies from the mothers in the control group. Babies from the colchicine group were early deliveries 15% of the time compared with only 6% of the babies not exposed to the drug. The colchicine babies did have a slight decrease in average birth weight compared to babies from the control group: 6.6% versus 7.3 pounds.

Ornoy comments that any of these effects might be caused by the illness that necessitated the need for treatment with colchicine, rather than being caused by the drug itself. All in all, the current study suggests that the use of colchicine in pregnant women is safe.