Date: March 2023, Version 2.1

Quick take

Certolizumab can be used in pregnancy to treat inflammatory illnesses. Babies who were exposed in later pregnancy might be offered some of their vaccinations at a later time than usual.

What is it? 

Certolizumab (Cimzia®) is an antibody therapy used to treat inflammatory illnesses, including psoriasis and certain types of arthritis.


What are the benefits of using certolizumab in pregnancy?

Certolizumab reduces inflammation by stopping the immune system from attacking the body’s tissues. This is important to reduce unpleasant symptoms and prevent long-term damage. It may also lower the chance of some pregnancy problems linked to uncontrolled inflammation, including miscarriage and lower infant birth weight. Certolizumab does not easily cross the placenta so only tiny amounts reach the baby. It is therefore not expected to cause problems in pregnancy.


What are the risks of using certolizumab in pregnancy?

There are no known risks. Use of certolizumab has been studied in around 1,400 pregnant women and there is no evidence that it affects the baby’s development.

Antibody treatments that work in the same way as certolizumab, but that cross the placenta easily, can affect the baby’s immune system after birth. Babies exposed to these medicines in later pregnancy are not usually given live vaccines (rotavirus or BCG) until they are a few months old to reduce the risk of vaccine complications. Although certolizumab does not easily cross the placenta, as a precaution, babies exposed in the womb might be offered live vaccinations at a later time than usual.


Are there any alternatives to using certolizumab in pregnancy?

Possibly. Other medicines can be used to treat inflammatory conditions during pregnancy, although these may not work as well as certolizumab. As certolizumab does not easily cross the placenta, staying on it during pregnancy may be the best option.
Women who are planning a pregnancy should speak to their specialist to determine which medicine is best. This can be arranged through the GP or specialist clinic.
If a woman becomes pregnant while taking certolizumab she should be reviewed by her doctor as soon as possible.

No treatment

What if I prefer not to take certolizumab during pregnancy?

It is important that inflammatory conditions are well-treated during pregnancy in order to avoid a flare-up of symptoms and to reduce the chance of certain pregnancy complications. A doctor will be happy to discuss any concerns.

Will I or my baby need extra monitoring? 

As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required, although extra growth scans may be offered.

Are there any risks to my baby if the father has used certolizumab?

There is currently no evidence that certolizumab used by the father can harm the baby through effects on the sperm.

Who can I talk to if I have questions? 

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.