Exposure to biologic therapy and associated maternal and neonatal outcomes in pregnancies complicated by inflammatory bowel disease

There is growing evidence that biologic therapy is safe in pregnancies complicated by inflammatory bowel disease and that its use outweighs the risk of worsening disease activity, which is associated with adverse pregnancy outcomes. To our knowledge, there are limited data regarding the use of biolo...

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Bibliographic Details
Published in:American journal of obstetrics & gynecology MFM 2022-01, Vol.4 (1), p.100518-100518, Article 100518
Main Authors: Rekawek, Patricia, Johnson, Shaelyn, Bigelow, Catherine A., Getrajdman, Chloe, Roy-McMahon, Christine, Stoffels, Guillaume, Dubinsky, Marla C., Mella, Maria T.
Format: Article
Language:English
Subjects:
antitumor necrosis factor alpha
Biological Therapy
biologics
Cesarean Section - adverse effects
Crohn Disease
Female
Humans
hypertensive outcome
Infant, Newborn
infectious outcome
inflammatory bowel disease
maternal morbidity
neonatal outcomes
Pregnancy
Pregnancy Outcome - epidemiology
Retrospective Studies
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Summary:There is growing evidence that biologic therapy is safe in pregnancies complicated by inflammatory bowel disease and that its use outweighs the risk of worsening disease activity, which is associated with adverse pregnancy outcomes. To our knowledge, there are limited data regarding the use of biologic therapy and the associated maternal adverse effects such as the risk of hypertensive outcomes, postoperative complications, and infectious risk. Our objective was to evaluate a variety of obstetrical complications including maternal infectious outcomes, hypertensive outcomes, other adverse maternal outcomes including postoperative complications, venous thromboembolism, and postpartum hemorrhage; we also evaluated the neonatal outcomes associated with biologic use in pregnancies affected by inflammatory bowel disease. This was a retrospective cohort study including patients with inflammatory bowel disease who were pregnant and delivered at our institution. The maternal demographics and the incidence of maternal and neonatal outcomes were compared among groups on the basis of biologic exposure using the chi-square or Fisher exact test for categorical variables and the t test or Mann-Whitney test for continuous variables. Multivariable logistic regression analysis was performed on composite outcomes adjusting for age, disease activity, maternal obesity, history of cesarean delivery, and history of corticosteroid use in pregnancy. The statistical significance was defined as P
ISSN:2589-9333
2589-9333
DOI:10.1016/j.ajogmf.2021.100518