Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Paediatric infections in the first 3 years of life after maternal anti-TNF treatment during pregnancy
Show others and affiliations
2020 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 52, no 5, p. 843-854Article in journal (Refereed) Published
Abstract [en]

Background: Most anti‐tumour necrosis factor (anti‐TNF) agents are transferred across the placenta and may increase paediatric susceptibility to infections.

Aims: To assess the risk of paediatric infections after maternal anti‐TNF treatment.

Methods: Population‐based cohort study in Denmark, Finland and Sweden 2006‐2013 in which 1027 children born to women with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis or inflammatory bowel disease, treated with anti‐TNF, and 9346 children to women with nonbiologic systemic treatment, were compared to 1 617 886 children of the general population. Children were followed for 3 years.

Results: Adjusted by maternal age, parity, smoking, body mass index, country and calendar year, the incidence rate ratios with 95% confidence interval (CI) for hospital admissions for infection in the first year were 1.43 (1.23‐1.67) for anti‐TNF and 1.14 (1.07‐1.21) for non‐biologic systemic treatment, and 1.29 (1.11‐1.50) and 1.09 (1.02‐1.15), respectively, when additionally adjusting for adverse birth outcomes. There was a slight increase in antibiotic prescriptions in the second year for anti‐TNF, 1.19 (1.11‐1.29), and for non‐biologic systemic treatment, 1.10 (1.07‐1.13). There was no difference among anti‐TNF agents, treatment in the third trimester, or between mono/combination therapy with non‐biologic systemic treatment.

Conclusions: Both anti‐TNF and non‐biologic systemic treatment were associated with an increased risk of paediatric infections. However, reassuringly, the increased risks were present regardless of treatment in the third trimester, with combination of treatments, and were not persistent across the first 3 years of life. Our findings may indicate a true risk, but could also be due to unadjusted confounding by disease severity and healthcare‐seeking behaviour. This may in turn shift the risk‐benefit equation towards continuation of treatment even in the third trimester.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020. Vol. 52, no 5, p. 843-854
National Category
Pharmacology and Toxicology Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-173912DOI: 10.1111/apt.15971ISI: 000551514600001PubMedID: 32706178Scopus ID: 2-s2.0-85088365708OAI: oai:DiVA.org:umu-173912DiVA, id: diva2:1456779
Available from: 2020-08-06 Created: 2020-08-06 Last updated: 2021-01-11Bibliographically approved

Open Access in DiVA

fulltext(708 kB)128 downloads
File information
File name FULLTEXT02.pdfFile size 708 kBChecksum SHA-512
76d073aba45a97fcf2ce8c99196c8cc48d68b51c975386667f6c424ced127695254598a80fa497a34d099a9af9f842624bcfd7fa7c257761045f9f833df79ecc
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Schmitt-Egenolf, Marcus

Search in DiVA

By author/editor
Bröms, GabriellaKieler, HelleEkbom, AndersSchmitt-Egenolf, Marcus
By organisation
Dermatology and Venerology
In the same journal
Alimentary Pharmacology and Therapeutics
Pharmacology and ToxicologyObstetrics, Gynecology and Reproductive MedicinePediatrics

Search outside of DiVA

GoogleGoogle Scholar
Total: 176 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 318 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf