title: Factors associated with pregnancy outcome in anti-TNF treated women with inflammatory bowel disease.
abstract: BACKGROUND
  The safety of anti-tumour necrosis factor (TNF) agents during pregnancy is a major concern for child-bearing women and physicians.
  
  
  OBJECTIVE
  To assess the impact of anti-TNF therapy on adverse pregnancy and foetal outcomes in women with inflammatory bowel disease (IBD).
  
  
  METHODS
  Pregnancies occurring during anti-TNF treatment or less than 3 months after its cessation in IBD patients followed in GETAID centres were recorded from January 2009 to December 2010. Ninety-nine pregnancies in women without anti-TNF treatment were identified from the CESAME registry. We compared pregnancy and neonatal outcomes by a case-control study.
  
  
  RESULTS
  In the 124 IBD patients followed, 133 pregnancies were reported. At the conception time, 23% of patients had active disease. Eighty-eight per cent (n = 117) of the 133 pregnancies followed until delivery resulted in 118 liveborns (one twin pregnancy). Complications were observed in 47 (35%) women and 24 (20%) newborns. In multivariate analysis, factors associated with pregnancy complications were: current smoking (P = 0.004), a B2 (stenotic) phenotype in CD women (P = 0.004), occurrence of a flare during pregnancy (P = 0.006) and a past history of complicated pregnancy (P = 0.007). Current smoking was the only factor associated with severe (i.e. potentially lethal) pregnancy complications (P = 0.02). Having IBD for more than 10 years prior to conception was associated with newborn complications (P = 0.007). No difference was found with the control group for any of the pregnancy and neonatal outcomes.
  
  
  CONCLUSIONS
  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.
authors: Beaujon University Hospital Paris VII University, Clichy, France; Geneva University Hospital, Geneva, Switzerland.
authors: M
authors: M
authors: Seirafi
authors: B
authors: B
authors: de Vroey
authors: A
authors: A
authors: Amiot
authors: P
authors: P
authors: Seksik
authors: X
authors: X
authors: Roblin
authors: M
authors: M
authors: Allez
authors: L
authors: L
authors: Peyrin-Biroulet
authors: P
authors: P
authors: Marteau
authors: G
authors: G
authors: Cadiot
authors: D
authors: D
authors: Laharie
authors: A
authors: A
authors: Boureille
authors: M
authors: M
authors: De Vos
authors: G
authors: G
authors: Savoye
authors: J-F
authors: JF
authors: Rahier
authors: F
authors: F
authors: Carbonnel
authors: B
authors: B
authors: Bonaz
authors: J-F
authors: JF
authors: Colombel
authors: Y
authors: Y
authors: Bouhnik
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy*; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000503:physiopathology; D011256:Pregnancy Outcome; D012042:Registries; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D014409:Tumor Necrosis Factor-alpha