Biologics and Pregnancy
What to know before, during, and after pregnancy while on biologic therapy
⚠️ Important
Never stop or start any biologic medication during pregnancy without consulting your rheumatologist, gastroenterologist, or OB/GYN. This page provides general educational information only — your care team will make individualized recommendations based on your specific condition, medication, and pregnancy timing.
Key Takeaways
- Uncontrolled autoimmune disease during pregnancy carries significant risks to mother and fetus
- Some biologics have more safety data in pregnancy than others
- Timing of doses relative to delivery may affect newborn immune function
- Cimzia (certolizumab pegol) has the lowest known placental transfer among TNF inhibitors
- All decisions should be made collaboratively with your specialist
Biologics and Placental Transfer
IgG antibody-based biologics (most monoclonal antibodies) cross the placenta via the FcRn receptor, with transfer increasing significantly in the second and third trimesters. This means the newborn may have detectable biologic levels at birth and for weeks to months afterward, which has implications for timing of the mother's last dose and the newborn's vaccine schedule (live vaccines should typically be delayed).
| Medication | Placental Transfer | General Guidance |
|---|---|---|
| Cimzia (certolizumab) | Minimal (PEGylated Fab, no Fc region) | Often considered when pregnancy is planned; discuss with specialist |
| Humira (adalimumab) | High in 3rd trimester | Some specialists stop last dose by week 34; individualized |
| Remicade (infliximab) | High in 3rd trimester | Individualized timing — discuss with gastroenterologist/rheumatologist |
| Entyvio (vedolizumab) | Moderate | Gut-selective; some data supports continued use; specialist guidance needed |
| Rinvoq / Xeljanz (JAK inhibitors) | Cross placenta | Generally not recommended in pregnancy — discuss stopping before conception |
💊 BiologicHealthPlus Supports You Through Pregnancy
We work closely with your care team to coordinate biologic supply, timing, and insurance coverage throughout your pregnancy. Our pharmacists are available 24/7.
Talk to a Pharmacist →📚 Sources & Further Reading
Content developed with reference to leading health organizations, peer-reviewed research, and FDA prescribing information.
Medical Disclaimer: Educational content reviewed by the BiologicHealthPlus Clinical Team. Consult your healthcare provider for personalized advice. Last reviewed: August 2026.