Anti-TNF treatment during pregnancy and birth outcomes: A population-based study from Denmark, Finland, and Sweden.
Adalimumab
/ adverse effects
Adult
Cesarean Section
Denmark
/ epidemiology
Etanercept
/ adverse effects
Female
Finland
/ epidemiology
Humans
Infant
Infant, Newborn
Pregnancy
Pregnancy Complications
Pregnancy Outcome
/ epidemiology
Premature Birth
Sweden
/ epidemiology
Tumor Necrosis Factor-alpha
/ antagonists & inhibitors
TNF inhibitor
adalimumab
anti-TNF
etanercept
inflammatory bowel disease
infliximab
pregnancy
rheumatoid arthritis
Journal
Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
02
05
2019
revised:
24
09
2019
accepted:
29
10
2019
pubmed:
6
2
2020
medline:
19
3
2021
entrez:
6
2
2020
Statut:
ppublish
Résumé
To study the risk of preterm birth, caesarean section, and small for gestational age after anti-tumor necrosis factor agent treatment (anti-TNF) in pregnancy. Population-based study including women with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis, and their infants born 2006 to 2013 from the national health registers in Denmark, Finland, and Sweden. Women treated with anti-TNF were compared with women with nonbiologic systemic treatment. Adalimumab, etanercept, and infliximab were compared pairwise. Continuation of treatment in early pregnancy was compared with discontinuation. Odds ratios with 95% confidence intervals were calculated in logistic regression models adjusted for country and maternal characteristics. Among 1 633 909 births, 1027 infants were to women treated with anti-TNF and 9399 to women with nonbiologic systemic treatment. Compared with non-biologic systemic treatment, women with anti-TNF treatment had a higher risk of preterm birth, odds ratio 1.61 (1.29-2.02) and caesarean section, 1.57 (1.35-1.82). The odds ratio for small for gestational age was 1.36 (0.96-1.92). In pairwise comparisons, infliximab was associated with a higher risk of severely small for gestational age for inflammatory joint and skin diseases but not for inflammatory bowel disease. Discontinuation of anti-TNF had opposite effects on preterm birth for inflammatory bowel disease and inflammatory joint and skin diseases. Anti-TNF agents were associated with increased risks of preterm birth, caesarean section, and small for gestational age. However, the diverse findings across disease groups may indicate an association related to the underlying disease activity, rather than to agent-specific effects.
Substances chimiques
Tumor Necrosis Factor-alpha
0
Adalimumab
FYS6T7F842
Etanercept
OP401G7OJC
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
316-327Informations de copyright
© 2020 John Wiley & Sons, Ltd.
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