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TNF-α inhibitor use during pregnancy and the risk of preeclampsia: population-based cohort study.
Adomi, Motohiko; McElrath, Thomas F; Hernández-Díaz, Sonia; Vine, Seanna M; Huybrechts, Krista F.
Afiliación
  • Adomi M; Department of Epidemiology, Harvard T.H. Chan School of Public Health.
  • McElrath TF; Department of Epidemiology, Harvard T.H. Chan School of Public Health.
  • Hernández-Díaz S; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Brigham and Women's Hospital.
  • Vine SM; Department of Epidemiology, Harvard T.H. Chan School of Public Health.
  • Huybrechts KF; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
J Hypertens ; 42(9): 1529-1537, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38690936
ABSTRACT

BACKGROUND:

Although the clinical importance of preeclampsia is widely recognized, few treatment options are available for prevention. TNF-α inhibitors have been hypothesized to potentially prevent the disease. We aimed to examine whether exposure to TNF-α inhibitors during pregnancy reduces the risk of preeclampsia.

METHODS:

We conducted a population-based pregnancy cohort study using nationwide samples of publicly (Medicaid data, 2000-2018) and commercially (MarketScan Research Database, 2003-2020) insured pregnant women linked to their liveborn infants. Exposure was ascertained based on a filled prescription or administration code for TNF-α inhibitors during the first and second trimester of pregnancy. The outcomes included early-onset preeclampsia, late-onset preeclampsia, and small-for-gestational age. For baseline confounding adjustment, we leveraged propensity score overlap weights to estimate risk ratios (RR).

RESULTS:

Among 4 315 658 pregnancies in the Medicaid and the MarketScan cohort, 2736 (0.063%) were exposed to TNF-α inhibitors during the first trimester and 1712 (0.040%) during the second trimester. After adjustment, the risk of early-onset preeclampsia was not decreased among mothers exposed during the first trimester compared with unexposed women with treatment indications [RR pooled 1.25, 95% confidence interval (CI) 0.93-1.67]. Similarly, the risk of late-onset preeclampsia was not decreased among mothers exposed during the second trimester compared with unexposed women (RR pooled 0.99, 95% CI 0.81-1.22).

CONCLUSION:

Contrary to the hypothesis, exposure to TNF-α inhibitors during pregnancy did not appear to be associated with a reduced risk of early-onset or late-onset preeclampsia. These findings do not support consideration of the use of TNF-α inhibitors for the prevention of preeclampsia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preeclampsia / Factor de Necrosis Tumoral alfa Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: J Hypertens Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preeclampsia / Factor de Necrosis Tumoral alfa Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: J Hypertens Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos