Most biologics undergo placental transfer during pregnancy and persist at detectable concentration in exposed infants. Whether this is associated with an increased risk of infantile infection was evaluated with a systematic review and meta-analysis, evaluating the risk of infantile infections after inutero exposure to biologics used to treat IBD
PubMed, Embase, Scopus, Web of Science and CENTRAL from inception to June 2020 were searched to evaluate the association of biologic therapy during pregnancy in women with IBD and risk of infantile infections. Odds ratios of outcomes were pooled and analyzed using a random effects model.
Nine studies met the inclusion criteria, comprising 8013 women with IBD (5212 Crohn’s disease, 2801 ulcerative colitis), who gave birth to 8490 infants. Biologic use during pregnancy was not associated with an increased risk of all infantile infection (OR 0.91). In a subgroup analysis for the type of infection, biologic use was associated with increased infantile upper respiratory infections (OR 1.57). Biologic use during pregnancy was not associated with infantile antibiotic use (OR 0.91), or infection-related hospitalizations (OR 1.33).
It was concluded that biologic use during pregnancy in women with IBD is not associated with the overall risk of infantile infection or serious infection requiring antibiotics or hospitalization, but is associated with increased risk of upper respiratory infections.
Gubatan, J., Nielsen, O., Levitte, S., et al. “Biologics During Pregnancy in Women with Inflammatory Bowel Disease and Risk of Infantile Infections: A Systematic Review and Meta-Analysis.” American Journal of Gastroenterology, 2021; Vol. 116, pp. 243-253.