Interferon-beta exposure in-utero and the risk of infections in early childhood.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 02 05 2023
revised: 09 06 2023
accepted: 29 06 2023
medline: 11 9 2023
pubmed: 10 7 2023
entrez: 9 7 2023
Statut: ppublish

Résumé

Knowledge within the field of multiple sclerosis treatment during pregnancy is vital to ensure the most optimal clinical practice. Immunomodulatory treatment in pregnancy could in theory affect the normal development and maturation of the immune system of the fetus with a potential increased risk of infections, consequently. We therefore set out to investigate whether exposure to interferon-beta in utero affected the risk of acquiring infections in early childhood. This retrospective matched cohort study utilized data from the Danish Multiple Sclerosis Registry linked with national Danish registries to identify all children born of mothers with MS in Denmark from 1998 to 2018. The study included 510 children exposed to interferon-beta in utero. The children were matched 1:1 on various of demographic characteristics with children born to mothers with untreated MS and 1:3 with children born to mothers without MS. Each child was followed for up to five years. Using individual-level data, we investigated all-cause mortality, rate of hospital admissions due to infections, and redeemed prescriptions of antibiotics. The primary statistical model applied was a negative binomial regression analysis. We found no differences in childhood mortality, for hospital admissions the rate ratio compared to healthy controls was 0.79 (0.62-1.00). Regarding antibiotic prescriptions, the results were similar (RR 1.00 (0.90-1.11). Furthermore, we found no certain dose-response relationship between interferon-beta exposure duration and hospital admission rate (P = 0.47) or redeemed antibiotic prescription (P = 0.71). Exposure to interferon-beta during gestation has little to no impact on the risk of acquiring significant infections during the first five years of childhood.

Sections du résumé

BACKGROUND BACKGROUND
Knowledge within the field of multiple sclerosis treatment during pregnancy is vital to ensure the most optimal clinical practice. Immunomodulatory treatment in pregnancy could in theory affect the normal development and maturation of the immune system of the fetus with a potential increased risk of infections, consequently. We therefore set out to investigate whether exposure to interferon-beta in utero affected the risk of acquiring infections in early childhood.
METHODS METHODS
This retrospective matched cohort study utilized data from the Danish Multiple Sclerosis Registry linked with national Danish registries to identify all children born of mothers with MS in Denmark from 1998 to 2018. The study included 510 children exposed to interferon-beta in utero. The children were matched 1:1 on various of demographic characteristics with children born to mothers with untreated MS and 1:3 with children born to mothers without MS. Each child was followed for up to five years. Using individual-level data, we investigated all-cause mortality, rate of hospital admissions due to infections, and redeemed prescriptions of antibiotics. The primary statistical model applied was a negative binomial regression analysis.
RESULTS RESULTS
We found no differences in childhood mortality, for hospital admissions the rate ratio compared to healthy controls was 0.79 (0.62-1.00). Regarding antibiotic prescriptions, the results were similar (RR 1.00 (0.90-1.11). Furthermore, we found no certain dose-response relationship between interferon-beta exposure duration and hospital admission rate (P = 0.47) or redeemed antibiotic prescription (P = 0.71).
CONCLUSION CONCLUSIONS
Exposure to interferon-beta during gestation has little to no impact on the risk of acquiring significant infections during the first five years of childhood.

Identifiants

pubmed: 37423048
pii: S2211-0348(23)00362-0
doi: 10.1016/j.msard.2023.104867
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104867

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Melinda Magyari has served on scientific advisory board, as consultant for, received support for congress participation or speaker honoraria from Biogen, Sanofi, Roche, Novartis, Merck, Alexion, Bristol Myers Squibb. The Danish MS Registry received research support from Biogen, Genzyme, Roche, Merck, Novartis. The rest of the authors declare that they have no conflict of interest.

Auteurs

Josefine Windfeld-Mathiasen (J)

Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, Copenhagen 2400, Denmark; Danish Multiple Sclerosis Registry, Department of Neurology, University Hospital-Rigshospitalet, Glostrup, Copenhagen, Denmark. Electronic address: josefine.windfeld-mathiasen@regionh.dk.

Henrik Horwitz (H)

Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, Copenhagen 2400, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Johanna Balslev Andersen (JB)

Danish Multiple Sclerosis Registry, Department of Neurology, University Hospital-Rigshospitalet, Glostrup, Copenhagen, Denmark.

Elisabeth Framke (E)

Danish Multiple Sclerosis Registry, Department of Neurology, University Hospital-Rigshospitalet, Glostrup, Copenhagen, Denmark.

Christina Gade (C)

Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, Copenhagen 2400, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Jon Trærup Andersen (JT)

Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, Copenhagen 2400, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Melinda Magyari (M)

Danish Multiple Sclerosis Registry, Department of Neurology, University Hospital-Rigshospitalet, Glostrup, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

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Classifications MeSH