SNFGE SNFGE
 
Thématique :
- MICI
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Professeur Vered ABITBOL-SELINGER
Coup de coeur :
 
 
The American Journal of Gastroenterology
  2018/11  
 
  2018 Nov;113(11):1678-1688.  
  doi: 10.1038/s41395-018-0202-9.  
 
  Pregnancy Outcomes Reported During the 13-Year TREAT Registry: A Descriptive Report  
 
  Lichtenstein GR, Feagan BG, Mahadevan U, Salzberg BA, Langholff W, Morgan GJ, Safdi M, Nissinen R, Taillard F, Sandborn WJ, Cohen RD  
  https://www.ncbi.nlm.nih.gov/pubmed/30022113  
 
 

Abstract

OBJECTIVES:

We described pregnancy outcomes in Crohn's disease (CD) patients enrolled in the TREAT Registry who received infliximab before, or during pregnancy and those not treated with infliximab or any biologic agent.

METHODS:

In the TREAT Registry (1999-2012), pregnancy outcomes were analyzed from maternal and paternal patients exposed to infliximab ≤365 days (gestational exposure), >365 days (pre-gestational exposure) of pregnancy outcome or without infliximab exposure (non-biologic exposed). "Healthy infants" were defined as those with no congenital abnormalities, neonatal complications (e.g., jaundice, prematurity, heart murmur, cortical vision/fine motor delay, cardiac failure, hemophilia, or torticollis), prolonged hospitalization, or those who received no special treatment. Disease activity and concomitant medications were also evaluated.

RESULTS:

Overall, 92.3% (324/351) of pregnancies had known outcomes. The majority of both maternal pregnancies (92.6, 91.2, and 87.8%) and partner outcomes (92.7, 93.8, and 91.7%) resulted in live births of healthy infants across gestational, pre-gestational, and non-biologic exposure groups, respectively. Among these, rates of neonatal complications were low for both maternal (6.2, 7.0, and 8.5%), and partner outcomes (4.9, 0, and 0%) in gestational, pre-gestational, and non-biologic exposure groups, respectively. Among maternal pregnancies, numerically higher rates of spontaneous abortions were observed for the gestational exposure group than for the pre-gestational or non-biologic exposed groups.

CONCLUSIONS:

The clinical condition of infants born to women with gestational infliximab exposure was similar to those without exposure. Although a lower live birth rate was reported among infliximab-exposed women, these patients had more severe CD and were more likely to have been exposed to immunosuppressives.

 

 
Question posée
 
Quelle est l’évolution des grossesses de patientes traitées par anti-TNF avant ou pendant la grossesse pour leur maladie de Crohn ?
 
Question posée
 
• Les enfants exposés in utero aux anti-TNF avaient la même évolution que les enfants non exposés • Le taux de naissances viables était inférieur chez les femmes exposées aux anti-TNF, mais ces patientes avaient une maladie de Crohn plus sévère et recevaient plus d’immunosuppresseurs
 
Commentaires

Données du registre TREAT aux Etats Unis. 

 
www.snfge.org