Anti-TNF-α Use During the Third Trimester of Pregnancy in Women with Moderate-severe Inflammatory Bowel Disease and the Risk of Preterm Birth and Low Birth Weight

Heidi Kammerlander, Jan Nielsen, Torben Knudsen, Jens Kjeldsen, Sonia Friedman, Bente Mertz Norgard

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: Little knowledge exists about the association between anti-tumor necrosis factor-alpha (anti-TNF-α) therapy for inflammatory bowel disease during late pregnancy and adverse birth outcomes. We aimed to examine whether treatment with anti-TNF-α during the third trimester affected preterm birth and low birth weight (LBW), compared with women who discontinued anti-TNF-α therapy before the third trimester.

METHODS: We identified a nationwide cohort of 219 women treated with anti-TNF-α during the pregnancy period and reviewed the medical records to extract clinical details. The exposed cohort (n = 113, 51.6%) constituted pregnancies exposed to anti-TNF-α during the third trimester, and the unexposed cohort (n = 106, 48.4%) constituted pregnancies with no anti-TNF-α during the third trimester. The association between anti-TNF-α therapy in the third trimester and adverse birth outcomes was studied (1) in those women who had clinical disease activity during pregnancy and (2) in women who had no clinical disease activity during pregnancy.

RESULTS: In women with disease activity, treated with anti-TNF-α during the third trimester, we found an adjusted odds ratio of 2.23 (95% confidence interval [CI], 0.80-6.20) for preterm birth and 1.16 (95% CI, 0.26-5.23) for LBW. Among women without disease activity, treated with anti-TNF-α therapy during the third trimester, we found an adjusted odds ratio of 3.36 (95% CI, 0.31-36.46) for preterm birth and 0.86 (95% CI, 0.05-14.95) for LBW.

CONCLUSIONS: For anti-TNF-α therapy in the third trimester, we found no statistically significant increased risk of either LBW or preterm birth.

Original languageEnglish
JournalInflammatory Bowel Diseases
Volume23
Issue number11
Pages (from-to)1916–1923
ISSN1078-0998
DOIs
Publication statusPublished - 2017

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Premature Birth
Third Pregnancy Trimester
Low Birth Weight Infant
Inflammatory Bowel Diseases
Tumor Necrosis Factor-alpha
Confidence Intervals
Odds Ratio
Medical Records

Keywords

  • Journal Article

Cite this

@article{4ab7b63daf6348eab6f2ed1658afd50e,
title = "Anti-TNF-α Use During the Third Trimester of Pregnancy in Women with Moderate-severe Inflammatory Bowel Disease and the Risk of Preterm Birth and Low Birth Weight",
abstract = "BACKGROUND: Little knowledge exists about the association between anti-tumor necrosis factor-alpha (anti-TNF-α) therapy for inflammatory bowel disease during late pregnancy and adverse birth outcomes. We aimed to examine whether treatment with anti-TNF-α during the third trimester affected preterm birth and low birth weight (LBW), compared with women who discontinued anti-TNF-α therapy before the third trimester.METHODS: We identified a nationwide cohort of 219 women treated with anti-TNF-α during the pregnancy period and reviewed the medical records to extract clinical details. The exposed cohort (n = 113, 51.6{\%}) constituted pregnancies exposed to anti-TNF-α during the third trimester, and the unexposed cohort (n = 106, 48.4{\%}) constituted pregnancies with no anti-TNF-α during the third trimester. The association between anti-TNF-α therapy in the third trimester and adverse birth outcomes was studied (1) in those women who had clinical disease activity during pregnancy and (2) in women who had no clinical disease activity during pregnancy.RESULTS: In women with disease activity, treated with anti-TNF-α during the third trimester, we found an adjusted odds ratio of 2.23 (95{\%} confidence interval [CI], 0.80-6.20) for preterm birth and 1.16 (95{\%} CI, 0.26-5.23) for LBW. Among women without disease activity, treated with anti-TNF-α therapy during the third trimester, we found an adjusted odds ratio of 3.36 (95{\%} CI, 0.31-36.46) for preterm birth and 0.86 (95{\%} CI, 0.05-14.95) for LBW.CONCLUSIONS: For anti-TNF-α therapy in the third trimester, we found no statistically significant increased risk of either LBW or preterm birth.",
keywords = "Journal Article",
author = "Heidi Kammerlander and Jan Nielsen and Torben Knudsen and Jens Kjeldsen and Sonia Friedman and Norgard, {Bente Mertz}",
year = "2017",
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language = "English",
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Anti-TNF-α Use During the Third Trimester of Pregnancy in Women with Moderate-severe Inflammatory Bowel Disease and the Risk of Preterm Birth and Low Birth Weight. / Kammerlander, Heidi; Nielsen, Jan; Knudsen, Torben; Kjeldsen, Jens; Friedman, Sonia; Norgard, Bente Mertz.

In: Inflammatory Bowel Diseases, Vol. 23, No. 11, 2017, p. 1916–1923.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Anti-TNF-α Use During the Third Trimester of Pregnancy in Women with Moderate-severe Inflammatory Bowel Disease and the Risk of Preterm Birth and Low Birth Weight

AU - Kammerlander, Heidi

AU - Nielsen, Jan

AU - Knudsen, Torben

AU - Kjeldsen, Jens

AU - Friedman, Sonia

AU - Norgard, Bente Mertz

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Little knowledge exists about the association between anti-tumor necrosis factor-alpha (anti-TNF-α) therapy for inflammatory bowel disease during late pregnancy and adverse birth outcomes. We aimed to examine whether treatment with anti-TNF-α during the third trimester affected preterm birth and low birth weight (LBW), compared with women who discontinued anti-TNF-α therapy before the third trimester.METHODS: We identified a nationwide cohort of 219 women treated with anti-TNF-α during the pregnancy period and reviewed the medical records to extract clinical details. The exposed cohort (n = 113, 51.6%) constituted pregnancies exposed to anti-TNF-α during the third trimester, and the unexposed cohort (n = 106, 48.4%) constituted pregnancies with no anti-TNF-α during the third trimester. The association between anti-TNF-α therapy in the third trimester and adverse birth outcomes was studied (1) in those women who had clinical disease activity during pregnancy and (2) in women who had no clinical disease activity during pregnancy.RESULTS: In women with disease activity, treated with anti-TNF-α during the third trimester, we found an adjusted odds ratio of 2.23 (95% confidence interval [CI], 0.80-6.20) for preterm birth and 1.16 (95% CI, 0.26-5.23) for LBW. Among women without disease activity, treated with anti-TNF-α therapy during the third trimester, we found an adjusted odds ratio of 3.36 (95% CI, 0.31-36.46) for preterm birth and 0.86 (95% CI, 0.05-14.95) for LBW.CONCLUSIONS: For anti-TNF-α therapy in the third trimester, we found no statistically significant increased risk of either LBW or preterm birth.

AB - BACKGROUND: Little knowledge exists about the association between anti-tumor necrosis factor-alpha (anti-TNF-α) therapy for inflammatory bowel disease during late pregnancy and adverse birth outcomes. We aimed to examine whether treatment with anti-TNF-α during the third trimester affected preterm birth and low birth weight (LBW), compared with women who discontinued anti-TNF-α therapy before the third trimester.METHODS: We identified a nationwide cohort of 219 women treated with anti-TNF-α during the pregnancy period and reviewed the medical records to extract clinical details. The exposed cohort (n = 113, 51.6%) constituted pregnancies exposed to anti-TNF-α during the third trimester, and the unexposed cohort (n = 106, 48.4%) constituted pregnancies with no anti-TNF-α during the third trimester. The association between anti-TNF-α therapy in the third trimester and adverse birth outcomes was studied (1) in those women who had clinical disease activity during pregnancy and (2) in women who had no clinical disease activity during pregnancy.RESULTS: In women with disease activity, treated with anti-TNF-α during the third trimester, we found an adjusted odds ratio of 2.23 (95% confidence interval [CI], 0.80-6.20) for preterm birth and 1.16 (95% CI, 0.26-5.23) for LBW. Among women without disease activity, treated with anti-TNF-α therapy during the third trimester, we found an adjusted odds ratio of 3.36 (95% CI, 0.31-36.46) for preterm birth and 0.86 (95% CI, 0.05-14.95) for LBW.CONCLUSIONS: For anti-TNF-α therapy in the third trimester, we found no statistically significant increased risk of either LBW or preterm birth.

KW - Journal Article

U2 - 10.1097/MIB.0000000000001234

DO - 10.1097/MIB.0000000000001234

M3 - Journal article

VL - 23

SP - 1916

EP - 1923

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 11

ER -