Continuing anti-tumor necrosis factor (anti-TNF) treatment after 24 weeks of gestation not only lowers the risk of inflammatory bowel disease (IBD) recurrence in pregnant women, but also reduces premature birth, a study has found.
The results of a study on the prognosis of anti-TNF therapy in pregnant women with inflammatory bowel disease, conducted by Professor Antoine Meyer of the Paris Public Hospital in France, were published on the 26th in the International Journal of Internal Medicine (doi.org/10.7326/M22-0819) (doi.org/10.7326/M22-0819) ).
About 3.3 million people in North America and 3.2 million people in Europe have Crohn’s disease or ulcerative colitis, which often affects young women during reproductive years.
The problem is that North American guidelines recommend continuing anti-TNF therapy throughout pregnancy, while European guidelines recommend stopping anti-TNF therapy for about 24 weeks.
The researchers analyzed data from the French National Health Data System (Systeme National des Donnees de Sante) who used anti-TNF after 24 weeks of pregnancy between 2010 and 2020 to examine changes in maternal, pregnancy and infant prognosis during early pregnancy. did.
The researchers looked at whether IBD recurred up to six months after conception, negative consequences for pregnancy, and serious infections in babies during the first five years of life.
Of the 184,115 women with IBD, 68,209 became pregnant between April 2010 and December 2020. Among them, 5413 patients received anti-TNF treatment before and after 24 weeks. Anti-TNF treatment was discontinued in 2,890 patients (54.6%) before 24 weeks and continued for more than 24 weeks in 2403 patients (45.4%).
As a result of the analysis, the effectiveness of anti-TNF treatment was observed in the reduction of the frequency of maternal IBD recurrence (35.8% vs. 39.0%) and in the side of continuing anti-TNF treatment due to premature birth (7.6% vs. 8.99%).
In stillbirth (0.4% vs. 0.2%), low body weight (13.1% vs. 12.9%), and infectious stillbirth (0.4% vs. 0.2%), no difference was found according to anti-TNF duration.
“The duration of anti-TNF after 24 weeks of gestation did not affect neonatal outcomes or serious infections,” the researchers concluded.