Impact of anti-TNFα exposure in utero on the development of immune systems of exposed children - A controlled, multicentre observational study
Abstract
Summary: Background: Data on safety of in utero exposure to anti-tumor necrosis factor (TNF) α on long-term childhood development are sparse. Our aim was to assess the impact of in utero exposure to anti-TNFα on the postnatal development of immune systems of exposed children.
Methods: Children (GREATER-THAN OR EQUAL TO 12 months of age) born to mothers with inflammatory bowel disease (IBD) (2007-2016) treated with anti-TNFα during pregnancy in three centres were included. Unexposed children of non-IBD mothers who came for mandatory check-up to the general pediatrician served as a control group.
A predefined questionnaire was distributed by the pediatricians to collect data on the perinatal period, infectious complications, antibiotic use, and vaccination. Results: We included 72 exposed and 69 unexposed children (median age 35 months and 50 months, respectively).
No significant difference in infectious complications LESS-THAN OR EQUAL TO 1st year of life (23.9 vs. 17.4%, p = 0.36) or during the whole follow-up (p = 0.32) was found between exposed infants and controls. Concomitant immunosuppressive therapy during pregnancy and anti-TNFα levels in cord blood did not increase the infection rate LESS-THAN OR EQUAL TO 1st year of life (p > 0.05).
Protective titers of antibodies to vaccination were found in > 95% of exposed children except for H. influenzae and mumps vaccines. However, these two vaccines had the lowest serologic response in the control group, too.
Conclusions: Treatment with anti-TNFα during pregnancy seemed to be safe with regard to postnatal development of the immune systems of exposed children. (C) 2018 Galen s.r.o. All rights reserved.