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BMC Medicine
Published in: BMC Medicine 1/2013

Open Access 01-12-2013 | Research article

Safety of TNF-α inhibitors during IBD pregnancy: a systematic review

Authors: Ole Haagen Nielsen, Edward V Loftus Jr, Tine Jess

Published in: BMC Medicine | Issue 1/2013

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Abstract

Background

Tumor necrosis factor (TNF)-α inhibitors are increasingly being used in inflammatory bowel disease (IBD). Because this chronic intestinal disorder often affects women of fertile age, it is essential to assess the effect of biologics on pregnancy outcome.

Methods

We performed a systematic review of the English-language literature to investigate if treatment with TNF-α blockers during pregnancy in women with IBD increases the risk of spontaneous abortions, preterm delivery, stillbirth, low birth weight, congenital malformations, or risk of infections in the offspring. Of 552 articles and abstracts reviewed, 58 articles or abstracts with unique content were identified and included in this systematic review. However, most presentations were case reports or case series supplied by a limited number of observational studies. No randomized controlled studies were available.

Results

TNF-α inhibitors do not seem to affect either outcome of pregnancy in mothers with IBD, or the outcome in the offspring (congenital malformations and immunosuppression). Further, recent data have not identified any increased risk of infections in the first year of life in the offspring of mothers who received biologics, even in combination with immunomodulators (thiopurines).

Conclusions

From the present systematic review, no association was found between administration of TNF inhibitors for IBD during pregnancy and adverse pregnancy outcome or congenital abnormalities. Further, no increased relative risk of infections has been reported in the first year of life in offspring of mothers who received biologics. Biologics should be discontinued during pregnancy solely if the IBD is in remission using the same stopping criteria as for patients with IBD in general, as uncontrolled activity of IBD may expose the mother and child to a risk greater than those only potentially coming from the use of TNF-α inhibitors. In such cases, inoculation of the offspring with live vaccines is contraindicated until the biologic agent is no longer detectable in the child’s circulation.
Appendix
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Literature
1.
Cornish J, Tan E, Teare J, Teoh TG, Rai R, Clark SK, Tekkis PP: A meta-analysis on the influence of inflammatory bowel disease on pregnancy. Gut. 2007, 56: 830-837.CrossRefPubMed
2.
Bortoli A, Saibeni S, Tatarella M, Prada A, Beretta L, Rivolta R, Politi P, Ravelli P, Imperiali G, Colombo E, Pera A, Daperno M, Carnovali M, de Franchis R, Vecchi M: Pregnancy before and after the diagnosis of inflammatory bowel diseases: retrospective case–control study. J Gastroenterol Hepatol. 2007, 22: 542-549.CrossRefPubMed
3.
Fonager K, Sorensen HT, Olsen J, Dahlerup JF, Rasmussen SN: Pregnancy outcome for women with Crohn’s disease: a follow-up study based on linkage between national registries. Am J Gastroenterol. 1998, 93: 2426-2430.CrossRefPubMed
4.
Nielsen OH, Andreasson B, Bondesen S, Jarnum S: Pregnancy in ulcerative colitis. Scand J Gastroenterol. 1983, 18: 735-742.CrossRefPubMed
5.
Nielsen OH, Andreasson B, Bondesen S, Jacobsen O, Jarnum S: Pregnancy in Crohn’s disease. Scand J Gastroenterol. 1984, 19: 724-732.PubMed
6.
Ferguson CB, Mahsud-Dornan S, Patterson RN: Inflammatory bowel disease in pregnancy. BMJ. 2008, 337: a427.CrossRefPubMed
7.
Mahadevan U, Kane S: American Gastroenterological Association Institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006, 131: 283-311.CrossRefPubMed
8.
Nielsen OH, Seidelin JB, Munck LK, Rogler G: Use of biological molecules in the treatment of inflammatory bowel disease. J Intern Med. 2011, 270: 15-28.CrossRefPubMed
9.
10.
Nielsen OH, Jess T: IBD: Can TNF inhibitors be administered during the third trimester?. Nat Rev Gastroenterol Hepatol. 2012, 10: 130-131.CrossRefPubMed
11.
Chaparro M, Gisbert JP: Transplacental transfer of immunosuppressants and biologics used for the treatment of inflammatory bowel disease. Curr Pharm Biotechnol. 2011, 12: 765-773.CrossRefPubMed
12.
Zelinkova Z, van der Ent C, Bruin KF, van Baalen O, Vermeulen HG, Smalbraak HJ, Ouwendijk RJ, Hoek AC, van der Werf SD, Kuipers EJ, van der Woude CJ: Effects of discontinuing anti-tumor necrosis factor therapy during pregnancy on the course of inflammatory bowel disease and neonatal exposure. Clin Gastroenterol Hepatol. 2013, 11: 318-321.CrossRefPubMed
13.
Friedman S, Regueiro MD: Pregnancy and nursing in inflammatory bowel disease. Gastroenterol Clin North Am. 2002, 31: 265-273.CrossRefPubMed
14.
Hou JK, Mahadevan U: A 24-year-old pregnant woman with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2009, 7: 944-947.CrossRefPubMed
15.
Oussalah A, Roblin X, Laharie D, Filippi J, Flamant M, Faure P, Phelip JM, Bigard MA, Peyrin-Biroulet L: Tumour necrosis factor antagonists and inflammatory bowel diseases: a national practice survey. Aliment Pharmacol Ther. 2009, 30: 854-863.CrossRefPubMed
16.
Vasiliauskas EA, Church JA, Silverman N, Barry M, Targan SR, Dubinsky MC: Case report: evidence for transplacental transfer of maternally administered infliximab to the newborn. Clin Gastroenterol Hepatol. 2006, 4: 1255-1258.CrossRefPubMed
17.
Mahadevan U, Wolf DC, Dubinsky M, Cortot A, Lee SD, Siegel CA, Ullman T, Glover S, Valentine JF, Rubin DT, Miller J, Abreu MT: Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013, 11: 286-292.CrossRefPubMed
18.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB: Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. JAMA. 2000, 283: 2008-2012.CrossRefPubMed
19.
Slama W, Roc E, Carlier P, Garayt C, Theophile H, Boyer M, et al: Pregnancy outcome in women exposed to anti tumor necrosis factor therapy. Congres de Physiologie, de Pharmacologie et de Therapeutique, Bordeaux, March 23–25, 2010. 2010, Oxford: Blackwell Publishing Ltd, 89.
20.
21.
Srinivasan R: Infliximab treatment and pregnancy outcome in active Crohn’s disease. Am J Gastroenterol. 2001, 96: 2274-2275.CrossRefPubMed
22.
Steenholdt C, Al-Khalaf M, Ainsworth MA, Brynskov J: Therapeutic infliximab drug level in a child born to a woman with ulcerative colitis treated until gestation week 31. J Crohns Colitis. 2012, 6: 358-361.CrossRefPubMed
23.
Arai K, Takeuchi Y, Oishi C, Imawari M: The impact of disease activity of Crohn’s disease during pregnancy on fetal growth. Clin J Gastroenterol. 2010, 3: 179-181.CrossRefPubMed
24.
Bank L, Hunt B: Unexpected dramatic clinical response of psoriasis lesions and unexpected pregnancy in an infertile patient in response to treatment with anti-tumor necrosis factor monoclonal antibody for Crohn’s disease. Am J Gastroenterol. 2002, 97: S260.CrossRef
25.
James RL, Pearson LL: Successful treatment of pregnancy-triggered Crohn’s disease complicated by severe recurrent life-threatening gastrointestinal bleeding. Am J Gastroenterol. 2001, 96: S295.CrossRef
26.
Angelucci E, Cocco A, Viscido A, Caprilli R: Safe use of infliximab for the treatment of fistulizing Crohn’s disease during pregnancy within 3 months of conception. Inflamm Bowel Dis. 2008, 14: 435-436.CrossRefPubMed
27.
Burt MJ, Frizelle FA, Barbezat GO: Pregnancy and exposure to infliximab (anti-tumor necrosis factor-alpha monoclonal antibody). J Gastroenterol Hepatol. 2003, 18: 465-466.CrossRefPubMed
28.
Mahadevan U, Terdiman JP, Church J, Vasiliauskas E, Gitis A, Dubinsky MC: Infliximab levels in infants born to women with inflammatory bowel disease. Gastroenterology. 2007, 132: A-144.CrossRef
29.
Malgarinos G, Gikas A, Delicha E, Stamataki A, Georgopoulos F, Papadimitriou A, Stanciu C, Triantafillidis JK: Pregnancy and inflammatory bowel disease: a prospective case–control study. Rev Med Chir Soc Med Nat Iasi. 2007, 111: 613-619.PubMed
30.
Correia LM, Bonilha DQ, Ramos JD, Ambrogini O, Miszputen SJ: Inflammatory bowel disease and pregnancy: report of two cases treated with infliximab and a review of the literature. Eur J Gastroenterol Hepatol. 2010, 22: 1260-1264.CrossRefPubMed
31.
Kane SV, Acquah LA: Placental transport of immunoglobulins: a clinical review for gastroenterologists who prescribe therapeutic monoclonal antibodies to women during conception and pregnancy. Am J Gastroenterol. 2009, 104: 228-233.CrossRefPubMed
32.
Mahadevan U, Kane S, Sandborn WJ, Cohen RD, Hanson K, Terdiman JP, Binion DG: Intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn’s disease. Aliment Pharmacol Ther. 2005, 21: 733-738.CrossRefPubMed
33.
34.
Tursi A: Effect of intentional infliximab use throughout pregnancy in inducing and maintaining remission in Crohn’s disease. Dig Liver Dis. 2006, 38: 439-440.CrossRefPubMed
35.
Casanova MJ, Chaparro M, Domenech E, Barreiro-de AM, Bermejo F, Iglesias E, Gomollon F, Rodrigo L, Calvet X, Esteve M, Garcia-Planella E, Garcia-Lopez S, Taxonera C, Calvo M, Lopez M, Ginard D, Gomez-Garcia M, Garrido E, Perez-Calle JL, Beltran B, Piqueras M, Saro C, Botella B, Duenas C, Ponferrada A, Manosa M, Garcia-Sanchez V, Mate J, Gisbert JP: Safety of thiopurines and anti-TNF-alpha drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol. 2013, 108: 433-440.CrossRefPubMed
36.
Lichtenstein GR, Feagan BG, Cohen RD, Salzberg BA, Diamond RH, Price S, Langholff W, Londhe A, Sandborn WJ: Serious infection and mortality in patients with Crohn’s disease: more than 5 years of follow-up in the TREAT registry. Am J Gastroenterol. 2012, 107: 1409-1422.CrossRefPubMedPubMedCentral
37.
Habal F: Biologic therapy in pregnancy and inflammatory bowel disease: a prospective 7 year study: clinical outcome. J Crohns Colitis. 2013, 7: S243.CrossRef
38.
Snoeckx Y, Clark M, Geldhof A, Morgan J, Nissinen R, Schlegelmilch J: Pregnancy outcomes in women with inflammatory bowel disease exposed to infliximab. J Crohns Colitis. 2013, 7: S170.CrossRef
39.
Traussnigg S, Eser A, Primas C, Papay P, Gratzer C, Angelberger S, Mikulits A, Reinisch W, Trauner M, Vogelsang H, Novacek G, Dejaco C: Adalimumab and infliximab therapy during pregnancy in IBD: a prospective assessment of outcome, safety and cord blood levels. J Crohns Colitis. 2013, 7: S252.CrossRef
40.
Abdul Wahab NA, Milner M: Inflammatory bowel disease in pregnancy: report of a case treated with infliximab and litterature review. Ir J Med Sci. 2011, 180: S131-S132.
41.
Kozeluhova J: Biological treatment of patient with ulcerative colitis during pregnancy. Cesk Sloven Gastroent Hepatol. 2011, 65: 75-77.
42.
Arguelles-Arias F, Castro-Laria L, Barreiro-de AM, Garcia-Sanchez MV, Guerrero-Jimenez P, Gomez-Garcia MR, Cordero-Ruiz P, Iglesias-Flores E, Gomez-Camacho F, Dominguez-Munoz EJ: Is safety infliximb during pregnancy in patients with inflammatory bowel disease?. Rev Esp Enferm Dig. 2012, 104: 59-64.CrossRefPubMed
43.
Machková N, Bortlik M, Duricova D, Bouzkova E, Lukas M: Pregnancy and newborn outcome of mothers with inflammatory bowel disease exposed to anti-TNF-alpha therapy during pregnancy. J Crohns Colitis. 2012, 6: S157.CrossRef
44.
Aratari A, Margagnoni G, Koch M, Papi C: Intentional infliximab use during pregnancy for severe steroid-refractory ulcerative colitis. J Crohns Colitis. 2011, 5: 262.CrossRefPubMed
45.
Chaparro M, Gisbert JP: Successful use of infliximab for perianal Crohn’s disease in pregnancy. Inflamm Bowel Dis. 2011, 17: 868-869.CrossRefPubMed
46.
Dunne C, Keegan D, Alakkari A, O’Donoghue D, Mulcahy H, Doherty GA: Pretty baby: successful use of anti-TNF-alpha therapy for Crohn’s disease in pregnancy. J Crohns Colitis. 2011, 5: S122.CrossRef
47.
Molnar T, Farkas K, Nagy F, Lakatos PL, Miheller P, Nyari T, Horvath G, Szepes Z, Marik A, Wittmann T: Pregnancy outcome in patients with inflammatory bowel disease according to the activity of the disease and the medical treatment: a case–control study. Scand J Gastroenterol. 2010, 45: 1302-1306.CrossRefPubMed
48.
Casanova MJ, Chaparro M, Flores EI, Rodrigo L, Mate J, Gisbert JP: Safety of immunomodulators and anti-TNF drugs for the treatment of inflammatory bowel disease during pregnancy. Gastroenterology. 2011, 140: S-266.
49.
Katz JA, Antoni C, Keenan GF, Smith DE, Jacobs SJ, Lichtenstein GR: Outcome of pregnancy in women receiving infliximab for the treatment of Crohn’s disease and rheumatoid arthritis. Am J Gastroenterol. 2004, 99: 2385-2392.CrossRefPubMed
50.
Zelinkova Z, de Haar C, de Ridder L, Pierik MJ, Kuipers EJ, Peppelenbosch MP, van der Woude CJ: High intra-uterine exposure to infliximab following maternal anti-TNF treatment during pregnancy. Aliment Pharmacol Ther. 2011, 33: 1053-1058.CrossRefPubMed
51.
Mahadevan U, Martin CF, Sandler RS, Kane S, Dubinsky MC, Lewis JD, Sandborn WJ, Sands BE: PIANO: a 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Updated presentation at the DDW 2012. Gastroenterology. 2012, 142: S-149.CrossRef
52.
Seirafi M, Treton X, de Vroey B, Cosnes J, Roblin X, Allez M, Marteau P, Biroulet LP, Bouhnik Y: Anti-TNF therapy and pregnancy in inflammatory bowel disease: a prospective cohort study from the GETAID. Gastroenterology. 2011, 140: S-175.
53.
Mahadevan U: Management of your pregnant IBD patients. AGA Spring Postgraduate Course. 2013, May, 18–19: 367-379.
54.
Schnitzler F, Fidder H, Ferrante M, Ballet V, Noman M, Van AG, Spitz B, Hoffman I, Van SK, Vermeire S, Rutgeerts P: Outcome of pregnancy in women with inflammatory bowel disease treated with antitumor necrosis factor therapy. Inflamm Bowel Dis. 2011, 17: 1846-1854.CrossRefPubMed
55.
Vinet E, Pineau C, Gordon C, Clarke AE, Bernatsky S: Biologic therapy and pregnancy outcomes in women with rheumatic diseases. Arthritis Rheum. 2009, 61: 587-592.CrossRefPubMed
56.
Carter JD, Ladhani A, Ricca LR, Valeriano J, Vasey FB: A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database. J Rheumatol. 2009, 36: 635-641.CrossRefPubMed
57.
Sandborn WJ, Hanauer SB, Katz S, Safdi M, Wolf DG, Baerg RD, Tremaine WJ, Johnson T, Diehl NN, Zinsmeister AR: Etanercept for active Crohn’s disease: a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2001, 121: 1088-1094.CrossRefPubMed
58.
Koren G, Inoue M: Do tumor necrosis factor inhibitors cause malformations in humans?. J Rheumatol. 2009, 36: 465-466.CrossRefPubMed
59.
Winger EE, Reed JL: Was risk properly assessed in Carter, et al’s safety assessment of tumor necrosis factor antagonists during pregnancy?. J Rheumatol. 2009, 36: 2122.CrossRefPubMed
60.
61.
O’Donnell S, O’Morain C: Review article: use of antitumour necrosis factor therapy in inflammatory bowel disease during pregnancy and conception. Aliment Pharmacol Ther. 2008, 27: 885-894.CrossRefPubMed
62.
Mahadevan U, Cucchiara S, Hyams JS, Steinwurz F, Nuti F, Travis SP, Sandborn WJ, Colombel JF: The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn’s and Colitis Organisation: pregnancy and pediatrics. Am J Gastroenterol. 2011, 106: 214-223.CrossRefPubMed
63.
Cheent K, Nolan J, Shariq S, Kiho L, Pal A, Arnold J: Case Report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn’s disease. J Crohns Colitis. 2010, 4: 603-605.CrossRefPubMed
64.
Xirouchakis E, Karantanos P, Tsartsali L, Karkatzos E: Pregnancy and Crohn’s disease: Infliximab induction therapy, accidental conception, pregnancy outcome and postpartum complications. Ann Gastroenterol. 2006, 19: 138-140.
65.
Angelucci E, Cesarini M, Vernia P: Inadvertent conception during concomitant treatment with infliximab and methotrexate in a patient with Crohn’s disease: is the game worth the candle?. Inflamm Bowel Dis. 2010, 16: 1641-1642.CrossRefPubMed
66.
Epping G, van der Valk PD, Hendrix R: Legionella pneumophila pneumonia in a pregnant woman treated with anti-TNF-alpha antibodies for Crohn’s disease: a case report. J Crohns Colitis. 2010, 4: 687-689.CrossRefPubMed
67.
Naganuma M, Kunisaki R, Yoshimura N, Nagahori M, Yamamoto H, Kimura H, Sako M, Kawaguchi T, Takazoe M, Yamamoto S, Matsui T, Hibi T, Watanabe M: Conception and pregnancy outcome in women with inflammatory bowel disease: A multicentre study from Japan. J Crohns Colitis. 2011, 5: 317-323.CrossRefPubMed
68.
Kane S, Ford J, Cohen R, Wagner C: Absence of infliximab in infants and breast milk from nursing mothers receiving therapy for Crohn’s disease before and after delivery. J Clin Gastroenterol. 2009, 43: 613-616.CrossRefPubMed
69.
Mahadevan U, Martin CF, Sandler RS, Kane SV, Dubinsky MC, Lewis JD, Sandborn WJ, Sands BE: One year newborn outcomes among offspring of women with inflammatory bowel disease: The PIANO Registry. Gastroenterology. 2010, 138: S-106.CrossRef
70.
Baker DE: Adalimumab: human recombinant immunoglobulin g1 anti-tumor necrosis factor monoclonal antibody. Rev Gastroenterol Disord. 2004, 4: 196-210.PubMed
71.
Bosworth BP, Inra J, Eswaran S, Scherl EJ: Failed use of adalimumab in maintaining remission in Crohn’s disease during pregnancy. Am J Gastroenterol. 2007, 102: S322.
72.
Johnson DL, Jones KL, Jimenez J, Mirrasoul BA, Salas E, Chambers CD: Pregnancy outcomes in women exposed to adalimumab: the OTIS autoimmune diseases in pregnancy project. Am J Gastroenterol. 2009, 104: S410.
73.
Abdul Wahab NA, Harkin R: Humira in pregnancy for Crohn’s disease: a case report. Ir J Med Sci. 2011, 180: S132.
74.
Ben-Horin S, Yavzori M, Katz L, Picard O, Fudim E, Chowers Y, Lang A: Adalimumab level in breast milk of a nursing mother. Clin Gastroenterol Hepatol. 2010, 8: 475-476.CrossRefPubMed
75.
Chambers CD, Johnson DL, Jones KL: Adalimumab and pregnancy outcome: The OTIS autoimmune disease in pregnancy project. Am J Gastroenterol. 2006, 101: S421-S422.
76.
Mahadevan U, Miller JK, Wolf DC: Adalimumab levels detected in cord blood and infants exposed in utero. Gastroenterology. 2011, 140: S61-S62.
77.
Coburn LA, Wise PE, Schwartz DA: The successful use of adalimumab to treat active Crohn’s disease of an ileoanal pouch during pregnancy. Dig Dis Sci. 2006, 51: 2045-2047.CrossRefPubMed
78.
Jürgens M, Brand S, Filik L, Hubener C, Hasbargen U, Beigel F, Tillack C, Goke B, Ochsenkuhn T, Seiderer J: Safety of adalimumab in Crohn’s disease during pregnancy: case report and review of the literature. Inflamm Bowel Dis. 2010, 16: 1634-1636.CrossRefPubMed
79.
Mishkin DS, Van DW, Becker JM, Farraye FA: Successful use of adalimumab (Humira) for Crohn’s disease in pregnancy. Inflamm Bowel Dis. 2006, 12: 827-828.CrossRefPubMed
80.
81.
82.
Gisbert JP: Safety of immunomodulators and biologics for the treatment of inflammatory bowel disease during pregnancy and breast-feeding. Inflamm Bowel Dis. 2010, 16: 881-895.CrossRefPubMed
83.
Osting VC, Carter JD: A safety assessment of tumor necrosis factor antagonists during pregnancy. Expert Opin Drug Saf. 2010, 9: 421-429.CrossRefPubMed
84.
Steinberg SA, Ulmann TA: Certolizumab treatment of linear IgA dermatosis in a pregnant Crohn’s colitis patient: a case study and review of the literature. Gastroenterology. 2010, 138: S-698.CrossRef
85.
Mahadevan U, Abreau MT: Certolizumab use in pregnancy: low levels detected in cord blood. Gastroenterology. 2009, 136: A-146.
86.
87.
Mahadevan U, Wolf DC, Stach C, Kosutic G, Williams S, Terpstra I, Clowse M: Outcomes of pregnancy in subjects exposed to certolizumab pegol. Am J Gastroenterol. 2012, 107: S621.
88.
Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D, Lichtiger S, D’Haens G, Diamond RH, Broussard DL, Tang KL, van der Woude CJ, Rutgeerts P: Infliximab, azathioprine, or combination therapy for Crohn’s disease. N Engl J Med. 2010, 362: 1383-1395.CrossRefPubMed
89.
Panaccione R, Ghosh S, Middleton S, Velazquez JRM, Khalif I, Flint L, van Hoogstraten HJ, Zheng H, Danese S, Rutgeerts P: Infliximab, azathioproine, or infliximab + azathioprine for treatment of moderate to severe ulcerative colitis: the UC SUCCESS trial. Gastroenterology. 2011, 140: S-134.
90.
Rychly DJ, DiPiro JT: Infections associated with tumor necrosis factor-alpha antagonists. Pharmacotherapy. 2005, 25: 1181-1192.CrossRefPubMed
91.
Treacy G: Using an analogous monoclonal antibody to evaluate the reproductive and chronic toxicity potential for a humanized anti-TNFalpha monoclonal antibody. Hum Exp Toxicol. 2000, 19: 226-228.CrossRefPubMed
92.
Roux CH, Brocq O, Breuil V, Albert C, Euller-Ziegler L: Pregnancy in rheumatology patients exposed to anti-tumour necrosis factor (TNF)-alpha therapy. Rheumatology (Oxford). 2007, 46: 695-698.CrossRef
93.
Marchioni RM, Blonski W, Lichtenstein GR: Anti-TNF inhibitor therapy and fetal risk: A systematic literature review. Gastroenterology. 2012, 142: S-248.CrossRef
94.
Melmed GY: Vaccination strategies for patients with inflammatory bowel disease on immunomodulators and biologics. Inflamm Bowel Dis. 2009, 15: 1410-1416.CrossRefPubMed
Metadata
Title
Safety of TNF-α inhibitors during IBD pregnancy: a systematic review
Authors
Ole Haagen Nielsen
Edward V Loftus Jr
Tine Jess
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2013
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-11-174

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