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Anti-Tumor Necrosis Factor Therapy and the Risk of Gestational Diabetes in Pregnant Women With Inflammatory Bowel Disease.

Authors :
Cho Y
Choi EY
Choi A
Han JY
Ye BD
Kim JH
Shin JY
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.)

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