{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:31:59Z","timestamp":1786977119568,"version":"build-2736575974"},"reference-count":11,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Leflunomide is a commonly used disease modifying antirheumatic agent. However, its use is contraindicated in pregnancy. The American College of Rheumatology (ACR) guidelines recommend discontinuing Leflunomide at least 24\u2009months before conception. If a woman is found to be pregnant while on Leflunomide, ACR suggests close monitoring and cholestyramine washout. We describe a case of a patient with a history of juvenile idiopathic arthritis who was on Leflunomide throughout the first and second trimester of her pregnancy. A cholestyramine washout regimen was started but not completed. The patient was induced at 37\u2009weeks of gestation due to non\u2010reassuring fetal heart rate. She ultimately delivered a healthy baby via emergency cesarian section.<\/jats:p>","DOI":"10.1002\/bdr2.2221","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T05:44:22Z","timestamp":1689659062000},"page":"1566-1569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Leflunomide exposure through second trimester of pregnancy: A case report"],"prefix":"10.1002","volume":"115","author":[{"given":"Rawan","family":"Alothman","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Yeung","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Waterman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa","family":"Lepik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Amiri","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"},{"name":"Arthritis Research Canada  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212078"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27358"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2007.05.006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2020.04.073"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24853"},{"key":"e_1_2_7_7_1","volume-title":"StatPearls","author":"Padda I. 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