Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life

被引：52

作者：

Kanis, Shannon Linda ^{[1
]}

Modderman, Sanne ^{[1
]}

Escher, Johanna C. ^{[2
]}

Erler, Nicole ^{[3
]}

Beukers, Ruud ^{[4
]}

de Boer, Nanne ^{[5
]}

Bodelier, Alexander ^{[6
]}

Depla, Annekatrien C. T. M. ^{[7
]}

Dijkstra, Gerard ^{[8
]}

van Dijk, Anne-Baue Ruth Margaretha ^{[1
]}

Gilissen, Lennard ^{[9
]}

Hoentjen, Frank ^{[10
]}

Jansen, Jeroen M. ^{[11
]}

Kuyvenhoven, Johan ^{[12
]}

Mahmmod, Nofel ^{[13
]}

Mallant-Hent, Rosalie C. ^{[14
]}

Van der Meulen-de Jong, Andrea E. ^{[15
]}

Noruzi, Anahita ^{[1
]}

Oldenburg, Bas ^{[16
]}

Oostenbrug, Liekele E. ^{[17
]}

Ter Borg, Pieter C. J. ^{[18
]}

Pierik, Marieke ^{[19
]}

Romberg-Camps, Marielle ^{[20
]}

Thijs, Willem ^{[21
]}

West, Rachel ^{[22
]}

de Lima, Alison ^{[1
]}

van der Woude, C. Janneke ^{[1
]}

机构：

[1] Erasmus MC, Gastroenterol & Hepatol, NL-3000 CA Rotterdam, Netherlands

[2] Erasmus MC Sophia Children Hosp, Pediat Gastroenterol, Rotterdam, Netherlands

[3] Erasmus MC, Biostat, Rotterdam, Netherlands

[4] Albert Schweitzer Ziekenhuis, Gastroenterol & Hepatol, Dordrecht, Netherlands

[5] Amsterdam UMC, Gastroenterol & Hepatol, Amsterdam, Netherlands

[6] Amphia Hosp Site Molengracht, Gastroenterol & Hepatol, Breda, Netherlands

[7] Slotervaart Hosp, Gastroenterol & Hepatol, Amsterdam, Netherlands

[8] Univ Groningen, Gastroenterol & Hepatol, Groningen, Netherlands

[9] Catharina Hosp, Gastroenterol & Hepatol, Eindhoven, Netherlands

[10] Radboudumc, Gastroenterol & Hepatol, Nijmegen, Netherlands

[11] Onze Lieve Vrouw Hosp, Gastroenterol & Hepatol, Amsterdam, Netherlands

[12] Spaarne Hosp, Gastroenterol & Hepatol, Haarlem, Netherlands

[13] Sint Antonius Ziekenhuis, Gastroenterol & Hepatol, Nieuwegein, Netherlands

[14] Flevo Hosp, Gastroenterol & Hepatol, Almere, Netherlands

[15] Leiden Univ, Gastroenterol & Hepatol, Med Ctr, Leiden, Netherlands

[16] Utrecht Hosp, Gastroenterol & Hepatol, Utrecht, Netherlands

[17] Zuyderland Med Ctr Heerlen, Gastroenterol & Hepatol, Heerlen, Netherlands

[18] Ikazia Hosp, Gastroenterol & Hepatol, Rotterdam, Netherlands

[19] Maastricht Univ, Med Ctr, Gastroenterol & Hepatol, Maastricht, Netherlands

[20] Zuyderland Med Ctr Sittard Geleen, Gastroenterol & Hepatol, Sittard Geleen, Netherlands

[21] Martini Hosp, Gastroenterol & Hepatol, Groningen, Netherlands

[22] Franciscus Gasthuis, Gastroenterol & Hepatol, Rotterdam, Netherlands

来源：

GUT | 2021年 / 70卷 / 07期

关键词：

TNF-ALPHA DRUGS; INTRAUTERINE EXPOSURE; PREGNANCY; WOMEN; IMMUNOGLOBULINS; AZATHIOPRINE; THIOPURINES; INFLIXIMAB; TRANSPORT; THERAPIES;

D O I：

10.1136/gutjnl-2019-319129

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objective The aim of this study was to describe the long-term health outcomes of children born to mothers with inflammatory bowel disease (IBD) and to assess the impact of maternal IBD medication use on these outcomes. Design We performed a multicentre retrospective study in The Netherlands. Women with IBD who gave birth between 1999 and 2018 were enrolled from 20 participating hospitals. Information regarding disease characteristics, medication use, lifestyle, pregnancy outcomes and long-term health outcomes of children was retrieved from mothers and medical charts. After consent of both parents, outcomes until 5 years were also collected from general practitioners. Our primary aim was to assess infection rate and our secondary aims were to assess adverse reactions to vaccinations, growth, autoimmune diseases and malignancies. Results We included 1000 children born to 626 mothers (381 (61%) Crohn's disease, 225 (36%) ulcerative colitis and 20 (3%) IBD unclassified). In total, 196 (20%) had intrauterine exposure to anti-tumour necrosis factor-alpha (anti-TNF-alpha) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-alpha and/or thiopurine served as control group. There was no association between adverse long-term health outcomes and in utero exposure to IBD treatment. We did find an increased rate of intrahepatic cholestasis of pregnancy (ICP) in case thiopurine was used during the pregnancy without affecting birth outcomes and long-term health outcomes of children. All outcomes correspond with the general age-adjusted population. Conclusion In our study, we found no association between in utero exposure to anti-TNF-alpha and/or thiopurine and the long-term outcomes antibiotic-treated infections, severe infections needing hospital admission, adverse reactions to vaccinations, growth failure, autoimmune diseases and malignancies.

引用

页码：1266 / 1274

页数：9

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