Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life

S.L. Kanis; S. Modderman; J.C. Escher; N. Erler; R. Beukers; N. de Boer; A. Bodelier; A.C.T.M. Depla; G. Dijkstra; A.B.R.M. van Dijk; L. Gilissen; F. Hoentjen; J.M. Jansen; J. Kuyvenhoven; N. Mahmmod; R.C. Mallant-Hent; A.E. Van der Meulen-de Jong; A. Noruzi; B. Oldenburg; L.E. Oostenbrug; P.C.J. Ter Borg; M. Pierik; M. Romberg-Camps; W. Thijs; R. West; A. de Lima; C.J. van der Woude; Initiative on Crohns and Colitis (ICC)

doi:10.1136/gutjnl-2019-319129

Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life

S.L. Kanis^*, S. Modderman, J.C. Escher, N. Erler, R. Beukers, N. de Boer, A. Bodelier, A.C.T.M. Depla, G. Dijkstra, A.B.R.M. van Dijk, L. Gilissen, F. Hoentjen, J.M. Jansen, J. Kuyvenhoven, N. Mahmmod, R.C. Mallant-Hent, A.E. Van der Meulen-de Jong, A. Noruzi, B. Oldenburg, L.E. OostenbrugP.C.J. Ter Borg, M. Pierik, M. Romberg-Camps, W. Thijs, R. West, A. de Lima, C.J. van der Woude, Initiative on Crohns and Colitis (ICC)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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-alpha (anti-TNF-alpha) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-alpha 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-alpha 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.

Original language	English
Pages (from-to)	1266-1274
Number of pages	9
Journal	Gut
Volume	70
Issue number	7
DOIs	https://doi.org/10.1136/gutjnl-2019-319129
Publication status	Published - 1 Jul 2021

Keywords

TNF-ALPHA DRUGS
INTRAUTERINE EXPOSURE
PREGNANCY
WOMEN
IMMUNOGLOBULINS
AZATHIOPRINE
THIOPURINES
INFLIXIMAB
TRANSPORT
THERAPIES

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Kanis, S. L., Modderman, S., Escher, J. C., Erler, N., Beukers, R., de Boer, N., Bodelier, A., Depla, A. C. T. M., Dijkstra, G., van Dijk, A. B. R. M., Gilissen, L., Hoentjen, F., Jansen, J. M., Kuyvenhoven, J., Mahmmod, N., Mallant-Hent, R. C., Van der Meulen-de Jong, A. E., Noruzi, A., Oldenburg, B., ... Initiative on Crohns and Colitis (ICC) (2021). Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life. Gut, 70(7), 1266-1274. https://doi.org/10.1136/gutjnl-2019-319129

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title = "Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life",

abstract = "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-alpha (anti-TNF-alpha) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-alpha 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-alpha 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.",

keywords = "TNF-ALPHA DRUGS, INTRAUTERINE EXPOSURE, PREGNANCY, WOMEN, IMMUNOGLOBULINS, AZATHIOPRINE, THIOPURINES, INFLIXIMAB, TRANSPORT, THERAPIES",

author = "S.L. Kanis and S. Modderman and J.C. Escher and N. Erler and R. Beukers and {de Boer}, N. and A. Bodelier and A.C.T.M. Depla and G. Dijkstra and {van Dijk}, A.B.R.M. and L. Gilissen and F. Hoentjen and J.M. Jansen and J. Kuyvenhoven and N. Mahmmod and R.C. Mallant-Hent and {Van der Meulen-de Jong}, A.E. and A. Noruzi and B. Oldenburg and L.E. Oostenbrug and {Ter Borg}, P.C.J. and M. Pierik and M. Romberg-Camps and W. Thijs and R. West and {de Lima}, A. and {van der Woude}, C.J. and {Initiative on Crohns and Colitis (ICC)}",

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doi = "10.1136/gutjnl-2019-319129",

language = "English",

volume = "70",

pages = "1266--1274",

journal = "Gut",

issn = "0017-5749",

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Kanis, SL, Modderman, S, Escher, JC, Erler, N, Beukers, R, de Boer, N, Bodelier, A, Depla, ACTM, Dijkstra, G, van Dijk, ABRM, Gilissen, L, Hoentjen, F, Jansen, JM, Kuyvenhoven, J, Mahmmod, N, Mallant-Hent, RC, Van der Meulen-de Jong, AE, Noruzi, A, Oldenburg, B, Oostenbrug, LE, Ter Borg, PCJ, Pierik, M, Romberg-Camps, M, Thijs, W, West, R, de Lima, A, van der Woude, CJ & Initiative on Crohns and Colitis (ICC) 2021, 'Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life', Gut, vol. 70, no. 7, pp. 1266-1274. https://doi.org/10.1136/gutjnl-2019-319129

TY - JOUR

T1 - Health outcomes of 1000 children born to mothers with inflammatory bowel disease in their first 5 years of life

AU - Kanis, S.L.

AU - Modderman, S.

AU - Escher, J.C.

AU - Erler, N.

AU - Beukers, R.

AU - de Boer, N.

AU - Bodelier, A.

AU - Depla, A.C.T.M.

AU - Dijkstra, G.

AU - van Dijk, A.B.R.M.

AU - Gilissen, L.

AU - Hoentjen, F.

AU - Jansen, J.M.

AU - Kuyvenhoven, J.

AU - Mahmmod, N.

AU - Mallant-Hent, R.C.

AU - Van der Meulen-de Jong, A.E.

AU - Noruzi, A.

AU - Oldenburg, B.

AU - Oostenbrug, L.E.

AU - Ter Borg, P.C.J.

AU - Pierik, M.

AU - Romberg-Camps, M.

AU - Thijs, W.

AU - West, R.

AU - de Lima, A.

AU - van der Woude, C.J.

AU - Initiative on Crohns and Colitis (ICC)

PY - 2021/7/1

Y1 - 2021/7/1

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-alpha (anti-TNF-alpha) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-alpha 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-alpha 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-alpha (anti-TNF-alpha) (60 with concomitant thiopurine) and 240 (24%) were exposed to thiopurine monotherapy. The 564 children (56%) not exposed to anti-TNF-alpha 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-alpha 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 - TNF-ALPHA DRUGS

KW - INTRAUTERINE EXPOSURE

KW - PREGNANCY

KW - WOMEN

KW - IMMUNOGLOBULINS

KW - AZATHIOPRINE

KW - THIOPURINES

KW - INFLIXIMAB

KW - TRANSPORT

KW - THERAPIES

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 -