Preterm Birth and in Utero Exposure to Corticosteroids Are Associated With Increased Infection Risk in Children of Mothers With IBD

• Published in: Inflammatory bowel diseases 2024-12, Vol.30 (12), p.2297
• Main Authors: Vestergaard, Thea, Holm Meiltoft, Ida, Julsgaard, Mette, Bek Helmig, Rikke, Friedman, Sonia, Kelsen, Jens
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Adult; Denmark - epidemiology; Female; Humans; Infant; Infant, Newborn; Infections - chemically induced; Infections - epidemiology; Infections - etiology; Inflammatory Bowel Diseases - drug therapy; Male; Pregnancy; Pregnancy Complications - drug therapy; Premature Birth - chemically induced; Premature Birth - epidemiology; Prenatal Exposure Delayed Effects - chemically induced; Retrospective Studies; Risk Factors
• ISSN: 1078-0998; 1536-4844; 1536-4844
• DOI: 10.1093/ibd/izad316

Corticosteroids, thiopurines, and biologics may come into play during pregnancy in women with inflammatory bowel disease and potentially impact the developing fetal immune system. We aimed to assess the risk of serious infections in children stratified by in utero exposure to biologics and immunomodulators or concomitant treatment with corticosteroids. All singleton IBD pregnancies between 2008 and 2022 at a tertiary IBD center in Denmark were included. Maternal and offspring demographics, maternal disease activity, antenatal medical treatment, and infant infections resulting in hospital admission were recorded after review of medical records. In 602 live births (99.0%), we registered exposure to antenatal treatment as follows: biological monotherapy (n = 61, 10.2%), thiopurines (n = 110, 17.9%), biologics and concomitant thiopurines (n = 63, 10.3%), and controls (ie, no treatment with biological and/or thiopurines; n = 369, 60.6%). Preterm delivery (