Decreased Risk of Preeclampsia in Women with Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2023 Jul 4

PMID 37402980

Authors

Nisha B Patel

Daniela Guerrero Vinsard

Andrea G Kattah

Sunanda V Kane

Affiliations

Soon will be listed here.

Abstract

Background: Evidence suggests that upregulation of tumor necrosis factor-alpha (TNF-α) plays a role in immune dysregulation in both preeclampsia and inflammatory bowel disease (IBD).

Aims: We aimed to investigate whether anti-TNF therapy during pregnancy decreases the risk of preeclampsia in women with IBD.

Methods: The study population included women with IBD and pregnancies who were followed at a tertiary care center from 2007 to 2021. Cases of preeclampsia were compared with controls with a normotensive pregnancy. Data on patient demographics, disease type and activity, pregnancy complications, and additional risk factors for preeclampsia were collected. The association between anti-TNF therapy and preeclampsia was analyzed using univariate analysis and multivariate logistic regression.

Results: Women with preeclampsia were more likely to have a preterm delivery (44% vs. 12%, p < 0.001). More women without preeclampsia were exposed to anti-TNF therapy during pregnancy than women with preeclampsia (55% vs. 30%, p = 0.029). The majority of women (32/44) on anti-TNF therapy, either adalimumab or infliximab, continued to have some degree of exposure during the third trimester. Though not significant, multivariate analysis showed a trend towards a protective effect of anti-TNF therapy against developing preeclampsia if exposed during the third trimester (OR 0.39; 95% CI 0.14-1.12, p = 0.08).

Conclusions: In this study, anti-TNF therapy exposure was higher in IBD patients who did not develop preeclampsia than in those who did. While not significant, there was a trend towards a protective effect of anti-TNF therapy against preeclampsia if exposed during the third trimester.

Citing Articles

Unveiling immune tolerance pathways in preeclampsia placenta: implications for molecular targets and discovery of potential biomarkers.

Ma Y, Deng X, Shen R, Zhang H, Qian Y Front Endocrinol (Lausanne). 2024; 15:1385154.

PMID: 38894741 PMC: 11182985. DOI: 10.3389/fendo.2024.1385154.

Obstetric outcomes of patients with inflammatory bowel disease.

Tondreau A, Breuval C, Gondry J, Fumery M, Foulon A Arch Gynecol Obstet. 2024; 310(2):943-951.

PMID: 38834885 DOI: 10.1007/s00404-024-07521-2.

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