Impact of anti-TNFα exposure in utero on the development of immune systems of exposed children – a controlled, multicentre observational study
Authors:
Ďuricová D. 1; Dvořáková E. 1; Hradský O. 2; Mitrová K. 1,2; Durilová M. 3; Koželuhová J. 4; Kohout P. 5; Zárubová K. 2; Bronský J. 2; Hradská N. 6; Bronská E. 7; Adamcová M. 7; Machková N. 1; Hrubá V. 1; Bortlík M. 1,8,9; Lukáš M. 1; Malíčková K. 1,10
Authors place of work:
Klinické a výzkumné centrum pro střevní záněty ISCARE I. V. F., a. s., Praha
1; Pediatrická klinika 2. LF UK a FN Motol, Praha
2; Klinika dětské chirurgie 2. LF UK a FN Motol, Praha
3; Gastroenterologické a hepatologické oddělení, I. interní klinika LF UK a FN v Plzni
4; Interní klinika 3. LF UK a Thomayerovy nemocnice, Praha6 Privátní ordinace PLDD, Litovel
5; Privátní ordinace PLDD, Praha
7; Interní klinika 1. LF UK a ÚVN, Praha
8; Farmakologický ústav 1. LF UK a VFN, Praha
9; Ústav lékařské biochemie a laboratorní diagnostiky, 1. LF UK a VFN, Praha
10
Published in the journal:
Gastroent Hepatol 2018; 72(6): 479-485
Category:
doi:
https://doi.org/10.14735/amgh2018479
Summary
Background:
Data on safety of in utero exposure to anti-tumor necrosis factor (TNF) α on long-term childhood development are sparse. Our aim was to assess the impact of in utero exposure to anti-TNFα on the postnatal development of immune systems of exposed children.
Methods:
Children (≥ 12 months of age) born to mothers with inflammatory bowel disease (IBD) (2007–2016) treated with anti-TNFα during pregnancy in three centres were included. Unexposed children of non-IBD mothers who came for mandatory check-up to the general pediatrician served as a control group. A predefined questionnaire was distributed by the pediatricians to collect data on the perinatal period, infectious complications, antibiotic use, and vaccination.
Results:
We included 72 exposed and 69 unexposed children (median age 35 months and 50 months, respectively). No significant difference in infectious complications ≤ 1st year of life (23.9 vs. 17.4%, p = 0.36) or during the whole follow-up (p = 0.32) was found between exposed infants and controls. Concomitant immunosuppressive therapy during pregnancy and anti-TNFα levels in cord blood did not increase the infection rate ≤ 1st year of life (p > 0.05). Protective titers of antibodies to vaccination were found in > 95% of exposed children except for H. influenzae and mumps vaccines. However, these two vaccines had the lowest serologic response in the control group, too.
Conclusions:
Treatment with anti-TNFα during pregnancy seemed to be safe with regard to postnatal development of the immune systems of exposed children.
Key words: inflammatory bowel disease – anti-TNFα – gravidity – infections – vaccination
Submitted: 22. 11. 2018
Accepted: 28. 11. 2018
Zdroje
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Štítky
Paediatric gastroenterology Gastroenterology and hepatology SurgeryČlánok vyšiel v časopise
Gastroenterology and Hepatology
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