TY - JOUR
T1 - Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life
AU - Kanis, Shannon Linda
AU - Modderman, Sanne
AU - Escher, Johanna C
AU - Erler, Nicole
AU - Beukers, Ruud
AU - de Boer, Nanne
AU - Bodelier, Alexander
AU - Depla, Annekatrien C T M
AU - Dijkstra, Gerard
AU - van Dijk, Anne-Baue Ruth Margaretha
AU - Gilissen, Lennard
AU - Hoentjen, Frank
AU - Jansen, Jeroen M
AU - Kuyvenhoven, Johan
AU - Mahmmod, Nofel
AU - Mallant-Hent, Rosalie C
AU - van der Meulen-de Jong, Andrea E
AU - Noruzi, Anahita
AU - Oldenburg, Bas
AU - Oostenbrug, Liekele E
AU - Ter Borg, Pieter C J
AU - Pierik, Marieke
AU - Romberg-Camps, Mariëlle
AU - Thijs, Willem
AU - West, Rachel
AU - de Lima, Alison
AU - van der Woude, C Janneke
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
PY - 2021/7
Y1 - 2021/7
N2 - 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-α (anti-TNF-α) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-α 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-α 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.
AB - 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-α (anti-TNF-α) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-α 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-α 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.
KW - azathioprine
KW - inflammatory bowel disease
KW - infliximab
KW - non-steroidal anti-inflammatory drugs
UR - http://www.scopus.com/inward/record.url?scp=85094646648&partnerID=8YFLogxK
U2 - 10.1136/gutjnl-2019-319129
DO - 10.1136/gutjnl-2019-319129
M3 - Article
C2 - 33046558
SN - 0017-5749
VL - 70
SP - 1266
EP - 1274
JO - Gut
JF - Gut
IS - 7
ER -