SynthesisBMC medicine2013
Safety of TNF-α inhibitors during IBD pregnancy: a systematic review.
Synthesis in BMC medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Adverse Pregnancy Outcomes Following Exposure to Biologics in Women With Crohn's Disease: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Inflammatory Bowel Disease Increases Risk of Adverse Pregnancy Outcomes: A Meta-Analysis.Digestive diseases and sciences · 2015Pooled it
- Biologic Therapy in Pregnant Women with Plaque Psoriasis: A Narrative Review of Maternal and Fetal Safety Considerations.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Pregnancy in Inflammatory Bowel Disease: Data from a Real-World Cohort in Germany.Journal of clinical medicine · 2024Article
- Trends in medications for autoimmune disorders during pregnancy and factors for their discontinuation: a population-based study.BMC pregnancy and childbirth · 2024Article
- Saudi consensus guidance for the management of inflammatory bowel disease during pregnancy.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2023Article
- Thiopurine Exposure During Pregnancy is Not Associated With Anemia in Infants Born to Mothers With IBD.Crohn's & colitis 360 · 2023Article
- Microbiota, co-metabolites, and network pharmacology reveal the alteration of the ginsenoside fraction on inflammatory bowel disease.Journal of ginseng research · 2023Article
- Pregnant women with immune mediated inflammatory diseases who discontinue biologics have higher rates of disease flare.Archives of gynecology and obstetrics · 2022Article
- Medical Treatment Options for Ulcerative Colitis.Clinics in colon and rectal surgery · 2022Review
- Biologics in Psoriasis: Updated Perspectives on Long-Term Safety and Risk Management.Psoriasis (Auckland, N.Z.) · 2022Review
- Immune function in newborns withFrontiers in pediatrics · 2022Article
- Review
- The use and impact of monoclonal antibody biologics during pregnancy.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Review
- Pregnancy and medications in inflammatory bowel disease.Obstetric medicine · 2021Review
- Pregnancy and Neonatal Outcomes After Fetal Exposure to Biologics and Thiopurines Among Women With Inflammatory Bowel Disease.Gastroenterology · 2021Observational
- IBD in pregnancy: recent advances, practical management.Frontline gastroenterology · 2021Review
- Tumor necrosis factor alpha (TNF-α) blockade improves natural killer cell (NK) activation, hypertension, and mitochondrial oxidative stress in a preclinical rat model of preeclampsia.Hypertension in pregnancy · 2020Article
- Treatment of Autoimmune Bullous Diseases During Pregnancy and Lactation: A Review Focusing on Pemphigus and Pemphigoid Gestationis.Frontiers in pharmacology · 2020Review
- Use of Biologic Therapy by Pregnant Women With Inflammatory Bowel Disease Does Not Affect Infant Response to Vaccines.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2018Article
Corrections and comments
- Commented on by
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTumor necrosis factor (TNF)-α inhibitors are increasingly being used in inflammatory bowel disease (IBD). Because this chronic intestinal disorder often affects women of fertile age, it is essential to assess the effect of biologics on pregnancy outcome.
methodsWe performed a systematic review of the English-language literature to investigate if treatment with TNF-α blockers during pregnancy in women with IBD increases the risk of spontaneous abortions, preterm delivery, stillbirth, low birth weight, congenital malformations, or risk of infections in the offspring. Of 552 articles and abstracts reviewed, 58 articles or abstracts with unique content were identified and included in this systematic review. However, most presentations were case reports or case series supplied by a limited number of observational studies. No randomized controlled studies were available.
resultsTNF-α inhibitors do not seem to affect either outcome of pregnancy in mothers with IBD, or the outcome in the offspring (congenital malformations and immunosuppression). Further, recent data have not identified any increased risk of infections in the first year of life in the offspring of mothers who received biologics, even in combination with immunomodulators (thiopurines).
conclusionsFrom the present systematic review, no association was found between administration of TNF inhibitors for IBD during pregnancy and adverse pregnancy outcome or congenital abnormalities. Further, no increased relative risk of infections has been reported in the first year of life in offspring of mothers who received biologics. Biologics should be discontinued during pregnancy solely if the IBD is in remission using the same stopping criteria as for patients with IBD in general, as uncontrolled activity of IBD may expose the mother and child to a risk greater than those only potentially coming from the use of TNF-α inhibitors. In such cases, inoculation of the offspring with live vaccines is contraindicated until the biologic agent is no longer detectable in the child's circulation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.