Evidence map›Paper›PMID 41327834›Full record

ArticleArthritis & rheumatology (Hoboken, N.J.)2026

Serious Infections in Offspring Exposed to Tumor Necrosis Factor Inhibitors During Pregnancy: Comparison of Timing During Pregnancy and Placental Transfer Ability.

Leah K Flatman, Sasha Bernatsky, Yvan St-Pierre, Marie-Eve Beauchamp, Isabelle Malhamé, Anick Bérard, Évelyne Vinet

Abstract readComparative Study
In one paragraph

Article in Arthritis & rheumatology (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Leah K FlatmanDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.ORCID 0000-0002-3719-1248
Sasha BernatskyDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.ORCID 0000-0002-9515-2802
Yvan St-PierreCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Marie-Eve BeauchampCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.ORCID 0000-0001-9488-0157
Isabelle MalhaméCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Anick BérardFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.ORCID 0000-0001-7535-5517
Évelyne VinetDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.ORCID 0000-0001-7727-5879

Funding

Arthritis Society PhD Salary Award 21-0000000084Arthritis Society PhD Salary Award STAR-19-0597CIHR FRN-181503CIHR PJT-166075CIHR PJT-180634Fonds de Recherche du Québec - Santé
6 · The paper itself

Abstract

objectiveWe evaluated serious infection risk in offspring exposed to tumor necrosis factor inhibitors (TNFi) in utero, separated by TNFi timing and placental transfer ability.

methodsUsing MarketScan (2011-2021), we identified offspring born to mothers with chronic inflammatory diseases. TNFi exposure was defined as at least one filled prescription during pregnancy, further subdivided by trimesters and placental transfer. The event of interest was the time to first hospitalization with infection in the offspring's first year of life. We estimated associations between TNFi exposure and infection risk using multivariable Cox proportional hazards models, adjusting for maternal demographics, disease type, comorbidities, pregnancy complications, and drug exposure.

resultsWe identified 56,866 offspring; 3,711 (6.5%) were exposed to TNFi during pregnancy. Overall, the association of TNFi exposure with the risk of serious infections vs unexposed offspring was not statistically significant (hazard ratio [HR] 0.85; 95% confidence interval [CI] 0.68-1.07). However, offspring exposed during the third trimester had a 70% higher risk of serious infections than those exposed only in the first and/or second trimesters (HR 1.70; 95% CI 0.96-3.01). Additionally, we observed an increased risk with exposure to any TNFi with high placental transfer ability (infliximab, adalimumab, golimumab) overall (HR 1.49; 95% CI 0.83-2.69) and during the third trimester (HR 1.30, 95% 0.65-2.61), compared to only low placental transfer TNFi (certolizumab, etanercept), though both HR were not statistically significant.

conclusionOverall, TNFi exposure was not associated with serious infections; exploratory signals by timing and placental transfer were imprecise and require confirmation.

Indexed as

InfectionsMaternal-Fetal ExchangePregnancy ComplicationsPrenatal Exposure Delayed EffectsTumor Necrosis Factor InhibitorsAdalimumabAdultFemaleHumansInfantInfant, NewbornInfliximabMalePregnancyTime FactorsTumor Necrosis Factor-alphaAdalimumabInfliximabTumor Necrosis Factor-alphaTumor Necrosis Factor Inhibitors

Identifiers

PMID41327834
PMCPMC13054462

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Registered trials

None linked

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.