Pregnant patients are often on immunosuppressant medications, most commonly to manage transplantation or autoimmune disorders. Most immunosuppressant agents, including tacrolimus, corticosteroids, azathioprine, and calcineurin inhibitors, are safe during pregnancy and lactation. However, mycophenolic acid is associated with higher risks of birth defects and should be avoided in pregnancy. Tacrolimus, the commonly used drug in transplantation medicine and autoimmune disorders, requires monitoring of serum levels for dose adjustment, particularly during pregnancy. Although no pregnancy-specific therapeutic range exists, the general target range is 5-15 ng/mL, and pregnant patients may require higher doses to achieve therapeutic levels. Adherence to prescribed immunosuppressive regimens is crucial to prevent graft rejection and autoimmune disorder flare-ups. This review aims to provide essential information about the use of immunosuppressant medications in pregnant individuals. With a rising number of pregnant patients undergoing organ transplantations or having autoimmune disorders, it is important to understand the implications of the use of these medications during pregnancy.

中文翻译：

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怀孕期间的免疫抑制剂药物。

怀孕患者经常服用免疫抑制剂，最常见的是为了治疗移植或自身免疫性疾病。大多数免疫抑制剂，包括他克莫司、皮质类固醇、硫唑嘌呤和钙调神经磷酸酶抑制剂，在怀孕和哺乳期间是安全的。然而，霉酚酸与出生缺陷的较高风险相关，因此在怀孕期间应避免使用。他克莫司是移植医学和自身免疫性疾病中常用的药物，需要监测血清水平以调整剂量，特别是在怀孕期间。尽管不存在妊娠特异性治疗范围，但一般目标范围为 5-15 ng/mL，妊娠患者可能需要更高剂量才能达到治疗水平。遵守规定的免疫抑制方案对于预防移植物排斥和自身免疫性疾病的发作至关重要。本综述旨在提供有关孕妇使用免疫抑制剂的基本信息。随着接受器官移植或患有自身免疫性疾病的怀孕患者数量不断增加，了解怀孕期间使用这些药物的影响非常重要。