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

Shannon Linda Kanis*, Sanne Modderman, Johanna C. Escher, Nicole Erler, Ruud Beukers, Nanne De Boer, Alexander Bodelier, Annekatrien C.T.M. Depla, Gerard Dijkstra, Anne Baue Ruth Margaretha Van Dijk, Lennard Gilissen, Frank Hoentjen, Jeroen M. Jansen, Johan Kuyvenhoven, Nofel Mahmmod, Rosalie C. Mallant-Hent, Andrea E. Van Der Meulen-De Jong, Anahita Noruzi, Bas Oldenburg, Liekele E. OostenbrugPieter C.J. Ter Borg, Marieke Pierik, Mariëlle Romberg- Camps, Willem Thijs, Rachel West, Alison De Lima, C. Janneke Van Der Woude

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

38 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)1266-1274
Number of pages9
Issue number7
Publication statusPublished - 2021

Bibliographical note

Funding Information:
This study was funded by ZonMW The Netherlands Organization for Health Research and Development, grant number 836021004.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

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  • EMC MM-04-54-07


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