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Anti-Tumor Necrosis Factor Therapy and the Risk of Gestational Diabetes in Pregnant Women With Inflammatory Bowel Disease.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2025 Jan 01; Vol. 120 (1), pp. 241-250. Date of Electronic Publication: 2024 Sep 24. - Publication Year :
- 2025
-
Abstract
- Introduction: Anti-tumor necrosis factor (anti-TNF) therapy may improve insulin sensitivity, and its impact during pregnancy remains unclear. We aimed to assess the risk of gestational diabetes mellitus (GDM) associated with anti-TNF treatment among pregnant women with inflammatory bowel disease (IBD).<br />Methods: This nationwide cohort study included patients with IBD in Korea from 2010 to 2021. Anti-TNF exposure was identified from the last menstrual period (LMP) to LMP + 140 days. The development of GDM was assessed from LMP + 141 days to delivery. We performed overlap weighting to balance the covariates and used a generalized linear mixed model to measure the risk ratio (RR) and 95% confidence intervals (CIs). The anti-TNF group was compared with the unexposed group, as well as with the immunosuppressant, 5-aminosalicylate, and untreated groups.<br />Results: A total of 3,695 pregnancies in women with IBD were identified, of which 338 (9.2%) were exposed to anti-TNFs. GDM was found in 7.1% of the pregnancies exposed to anti-TNFs as compared with 11.0% of those unexposed. The crude and weighted RRs for GDM risk were 0.64 (95% CI 0.43-0.96) and 0.68 (95% CI 0.55-0.84), respectively. The weighted RR when compared with the immunosuppressant, 5-aminosalicylate, and untreated groups was 0.70 (95% CI 0.41-1.18), 0.71 (95% CI 0.52-0.95), and 0.85 (95% CI 0.59-1.24), respectively.<br />Discussion: This nationwide cohort reported a decreased risk of GDM among patients who used anti-TNFs during early pregnancy compared with those unexposed. GDM risk may become a consideration in the decision-making process when choosing treatment options for pregnant women with a risk factor for GDM.<br /> (Copyright © 2024 by The American College of Gastroenterology.)
- Subjects :
- Humans
Female
Pregnancy
Adult
Republic of Korea epidemiology
Tumor Necrosis Factor Inhibitors therapeutic use
Tumor Necrosis Factor Inhibitors adverse effects
Tumor Necrosis Factor-alpha antagonists & inhibitors
Risk Factors
Cohort Studies
Immunosuppressive Agents adverse effects
Immunosuppressive Agents therapeutic use
Pregnancy Complications drug therapy
Pregnancy Complications epidemiology
Diabetes, Gestational epidemiology
Diabetes, Gestational drug therapy
Inflammatory Bowel Diseases drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1572-0241
- Volume :
- 120
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 39315687
- Full Text :
- https://doi.org/10.14309/ajg.0000000000003100