The safety of anti-tumour necrosis factor (TNF) agents during pregnancy is a major concern for child-bearing women and physicians.
Dr Bouhnik and colleagues from France assessed the impact of anti-TNF therapy on adverse pregnancy and fetal outcomes in women with inflammatory bowel disease (IBD).
Pregnancies occurring during anti-TNF treatment or less than 3 months after its cessation in IBD patients followed in GETAID centers were recorded from 2009 to 2010.
The research team identified 99 pregnancies in women without anti-TNF treatment from the CESAME registry.
|Complications were observed in 35% of women|
|Alimentary Pharmacology & Therapeutics|
The team compared pregnancy and neonatal outcomes by a case–control study.
In the 124 IBD patients followed, 133 pregnancies were reported.
At the conception time, 23% of patients had active disease.
The team observed that 88% of the 133 pregnancies followed until delivery resulted in 118 liveborns.
Complications were observed in 35% of women, and 20% of newborns.
The team found that factors associated with pregnancy complications were current smoking, a B2 phenotype in Crohn's disease women, occurrence of a flare during pregnancy, and a past history of complicated pregnancy.
The team determined that current smoking was the only factor associated with severe pregnancy complications.
Having IBD for more than 10 years prior to conception was associated with newborn complications.
No difference was found with the control group for any of the pregnancy and neonatal outcomes.
Dr Bouhnik's team comments, "In our series, the safety profile of anti-TNF therapy during pregnancy and the neonatal period appears similar to control group of IBD women not treated with anti-TNF therapy."