In patients with SLE choosing to continue azathioprine during pregnancy, what potential risk should they be aware of?

Patients with systemic lupus erythematosus (SLE) who opt to continue azathioprine during pregnancy should be aware of several potential risks associated with this medication.

Firstly, azathioprine is an immunosuppressive drug, which can lead to a decreased immune response in both the mother and the fetus. This results in an increased risk of infection, as the body may not be able to effectively combat pathogens due to the immunosuppressive effects of the medication.

There is also evidence suggesting that the use of azathioprine during pregnancy may be associated with an increased risk of miscarriage. This concern stems from the drug's effects on fetal development and the mother's overall health during pregnancy.

Moreover, azathioprine has been linked to possible neurodevelopment issues in infants if exposed in utero. There is ongoing research in this area, but some studies indicate that the medication could potentially affect the cognitive and developmental outcomes of the child.

Given these multifaceted risks – increased risk of infection, miscarriage, and neurodevelopmental issues – it is prudent for patients to be aware of the comprehensive potential impacts of continuing azathioprine during pregnancy. Therefore, the correct response encompasses all these concerns collectively.