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Pregnant women with inflammatory bowel disease: the effects of biologicals on pregnancy,outcome of infants,and the developing immune system |
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| Authors: | Jantien W. Wieringa Gertjan J. Driessen C. Janneke Van Der Woude |
| Affiliation: | 1. Department or Pediatrics, Haaglanden Medical Center, The Hague, The Netherlands;2. Department of Pediatric Infectious Diseases and Immunology, Erasmus Medical Centre-Sophia Children’s Hospital, Rotterdam, The Netherlands;3. Department of Pediatrics, Haga Teaching Hospital, Juliana Children’s Hospital, The Hague, The Netherlands;4. Department of Gastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands |
| Abstract: | Introduction: Relapse of inflammatory bowel disease (IBD) during conception and pregnancy has been associated with a negative pregnancy outcome. Therefore, it is advised to maintain drugs in order to prevent relapse. The effect of drugs, which cross the placenta, on children who have been exposed during pregnancy will be discussed in this review. Areas covered: A literature search was performed using the following search terms: inflammatory bowel disease, pregnancy, infant, antitumor necrosis factor alpha, infliximab, adalimumab, golimumab, certolizumab, anti-integrins, vedolizumab, anti-interleukin (IL)-12/23 ustekinumab, placenta, vaccination. Other studies were identified by using references from articles identified through our original literature search. The occurrence of unfavorable pregnancy outcome and congenital malformations does not seem to be increased after exposure to anti-TNFα, but the effects on the developing immune system are largely unknown. For anti-integrins and anti IL-12/23, the numbers of exposed pregnancies are too small to draw any conclusions. Expert commentary: Follow-up of the developing immune system in children exposed to these drugs seems warranted, preferably in a prospective study design. |
| Keywords: | Anti-TNFα anti-integrins anti-interleukin 12/23 child inflammatory bowel disease pregnancy outcome |