Evidence map›Paper›PMID 42183927›Full record

SynthesisDigestive diseases and sciences2026

Pairwise Comparative Safety and Effectiveness of Anti-TNF Blockers, Vedolizumab, and Ustekinumab During Pregnancy: A Systematic Review and Meta-Analysis.

Omotayo Segun-Omosehin, Natalie E Bourdakos, Kosta G Tzanis, Marie Michele Macaron, Fares Jamal, Lisa Marks, Abdullah Hamad, Talha A Malik

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Omotayo Segun-Omosehin *Department of Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
Natalie E Bourdakos *Department of General Surgery, Guthrie Robert Packer Hospital, Sayre, PA, 18840, USA.
Kosta G TzanisUniversity of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus.
Marie Michele MacaronUniversity of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus.
Fares JamalDivision of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, 85054, USA.
Lisa MarksLibrary Services, Mayo Clinic, Phoenix, AZ, 85054, USA.
Abdullah HamadDivision of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, 85054, USA.
Talha A MalikDivision of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, 85054, USA. Malik.Talha@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBiologic therapies, including tumor necrosis factor (TNF) blockers, vedolizumab (VDZ), and ustekinumab (UST), are generally considered safe during pregnancy in patients with inflammatory bowel disease (IBD), though comparative data remain limited. This meta-analysis examines their safety and effectiveness.

methodsA systematic search of MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science was conducted through July 2025. Eligible studies reported maternal or neonatal outcomes in pregnant IBD patients treated with biologics. Studies were pooled using a random-effects model to calculate risk ratios (RRs) with 95% confidence intervals. Heterogeneity was assessed using I

resultsNine observational studies (n = 6,054) were included. Compared to TNF blockers, VDZ was associated with a higher risk of preterm delivery (RR = 1.35, 95% CI 1.04-1.75, I

conclusionTNF blockers showed a favorable safety and effectiveness profile, VDZ and UST performed broadly similar, and all three biological classes appeared compatible with safe use in pregnancy to maintain effective disease control. Observed differences reflect that VDZ and UST cohorts likely had longer disease duration, prior biologic exposure, and more active disease. The results of this meta-analysis support the continuation of biologic therapy for disease control in pregnant patients with IBD. Treatment decisions should be individualized and tailored to each patient's clinical context.

Indexed as

Antibodies, Monoclonal, HumanizedGastrointestinal AgentsInflammatory Bowel DiseasesPregnancy ComplicationsTumor Necrosis Factor InhibitorsUstekinumabFemaleHumansPregnancyPregnancy OutcomePremature BirthTreatment OutcomeTumor Necrosis Factor-alphaAntibodies, Monoclonal, HumanizedGastrointestinal AgentsTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsUstekinumabvedolizumabBiologicsInflammatory bowel diseaseMeta-analysisPregnancySystematic review

Identifiers

PMID42183927

What OpenQuestion holds

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Registered trials

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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.